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Multiple time donator - first question ever
Jan 7, 2008

Hi Doctor,

I'd like to thank you for the valuable information and compassion you provide us all.

I've read your forums in the past, as a self admitted worrier, but I have recently had a very real risk and have been having some very real symptoms.

Eleven weeks ago I had a condom break while having sex with a sex worker. I stopped within seconds but the shaft of my penis was exposed and it had exposed, raw patches of skin from a previous enounter. The healing skin had been rubbed off again and the abrasions were fresh. I then experienced the following symptoms: Weeks 3 and 4- Very bad cold symptoms of stuffy runny nose and sore throat. Week 5 - What felt like a sunburned chest and forehead for 4 days. There was no appearance of rash or red spots, just a burning sensation. Often, and still, my eyelids seem to burn when closed. Week 7 - Headache and sore neck and muscles, lasting a week. My glands were swollen like I had never felt before, under my jaw and running up to my ears. My glands under my armpits and into my biceps and elbows ached. The glands lasted about 10 days. Week 8-11(today)- For the last 4 weeks all of my joints ache. My ankles, elbows, knees, wrists and even fingers. I am not being paranoid, I have never felt anything like this before.

At the end of week 6 I went for a HIV test at a local Canadian clinic (I presume an antibody test) and was negative. I will go get tested after 90 days regardless of your answers, as I understand from you this is important.

Let me presume the woman was positive and my corresponding odds of infection are 5 in 10,000. I would assume the fresh raw abrasions increase the odds against me substantially. Your recent answers to others this week have been very helpful, but I do have some questions.

1) I know from reading here that there is no standard symptoms, but mine surely fit the mould. I've read the "cold like" symptoms of congestion and runny nose are not usual symptoms, and for me these showed up at the 14 day mark. My burning chest (I had no fever at anytime) did not occur until week 5 with my current joint pains lasting though week 11. Is this length of time atypical? Should my sypmtoms of primary HIV have resolved by now or would I expect the arthragia to linger on after the 6 week mark?

2) Does Canada (specifically Edmonton Alberta if you know) use newer generation tests? I'm wondering if my neg test after 6 weeks is a good sign, or meaningless.

3) When do antibodies show up in a test? Is it after your symptoms have resolved? My test (day 42) was 8 days after my burning skin stopped, is that enough time for antibodies to show up? My headaches and sore glands and muscles did not start until week 7 which was after my test.

I know what you do is a vague science and you will have no definative answers for me, but I have lost many sleepless nights and have tried my best to ask as direct questions as possible.

Thank you for your time,

Sleepless

Response from Dr. Frascino

Hello Sleepless,

1. Regarding ARS (acute retroviral syndrome) symptoms, there really is no mold to fit! Just a collection of very nonspecific symptoms, all of which are variable in severity and could have many causes other than HIV. As for duration of ARS symptoms, this too is quite variable. Generally they can last for two to three weeks.

2. You can check with your testing center regarding what generation of testing assay they are currently using. A negative six-week test is very encouraging, but not definitive.

3. Detectable levels of anti-HIV antibodies generally appear within four to six weeks, but can take as long as three months in some folks.

Sleepless, stop worrying yourself into a state of insomnia trying to precisely identify the natural history timeline for HIV disease, exact details of anti-HIV antibody production and the diagnostic significance of vague symptoms. None of this is at all helpful. Nor will it change the outcome of your tests. You had a very brief potential HIV exposure. You've had an encouraging negative six-week test. You need a definitive HIV test at the three-month mark. It's really just that straightforward, no matter what symptoms you may have or how raw the patches were on your one-eyed monster.

I'm sending you my good-luck karma that your definitive three-month test remains negative and that you'll soon be WOO-HOOing! Until then relax and get some sleep. Those bags and dark circles under your eyes are a bad fashion statement!

Dr. Bob



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