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Symptoms & Transmission Risk
Mar 25, 2009

Hi Dr Bob,

Before I start I would like to take this opportunity to thank you on behalf of myself and all other visitors to this forum for your generous, informative and always humourous responses. These past few months have been incredibly difficult for me and you are one of the few people that has made me genuinely laugh out loud during this time, so for this I thank you.

I have been experiencing symptoms that are all in keeping with those of HIV infection; initially I had a 6 week illness two weeks after potential exposure that included all the major symptoms, Joint Pain, Fatigue, Sore Throat and Swollen Lymph nodes in my neck. These acute symptoms have now subsided however I am still feeling fatigued and I have reactive lymph node enlargement in my neck, this is now three months after the initial illness. I have visited the doctor and been tested for Monoclueosis, Chlamydia, Gonorreah and had blood counts etc done. These have all come back negative and normal. Obviously the next stage is to get tested for HIV, the reason that I havent already been tested is that my GP is unaware of the potential exposure and therefore has not red flagged me for testing. I know I should be upfront with my doctor to ensure he can make an assesment on my condition with all the facts at his disposal, however I wanted to rule out other factors as once this has been entered into my medical notes I am at the mercy of insurance and mortgage company enquiries. Anyhow, the reason I am writing to you is that my exposure was not conventional and I would lie your opinion regarding it before I have my test carried out. I was involvd in a physical altercation with two men who attempted to mug/beat me although I was intoxicated at the time and my memory is a little hazy regarding their intentions. I sustained cuts to my face, hands and neck as well as inflicting injuries to my would be assailants. There was a fair level of bleeding involved and I know not all of it was mine. Therefore I was wondering waht you assesment of the transmission risk is in this case, also noting that I have and am continuing to display symptoms? I thank you for your valuable time and I will let you know how I get on with my results as soon as I have them. In the meantime I will send a donation and my best wishes to you for all your good work in the fields of medicine and comedy.

Many Thanks

From the UK

Response from Dr. Frascino

Hi UK-guy,

Your HIV-acquisition risk is remote at best. The chances your assailants were HIV positive and managed to get an adequate amount of their fresh HIV-positive blood into one of your fresh open wounds during your mugging (or whatever) such that you become HIV infected are negligible. Besides, because of your multiple Piña Coladas, your memory of your attacker's intentions is a little hazy. They could have been two ordinary blokes who were trying to tell you that you won the lottery for all you know.

Regarding symptoms, they are notoriously unreliable in predicting who is and is not HIV infected.

An HIV test at the three-month mark will provide a definitive test result. The odds are astronomically in your favor that you did not contract HIV from your little dustup.

Thank you for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending you my good-luck karma that your definitive HIV test is negative. I'm confident it will indeed be negative.

Good luck.

Dr. Bob



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