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Every Possible symptom
May 9, 2009

12 weeks ago I had my first sexual encounter ever, receptive anal sex with another man. Although it was protected at first, he took off the condom when he went soft and put it back on again. I was too stupid to stop him. The next day I found some pills in his cabinet and later found out that they were anti-HIV pills 'Truvada' I cannot believe my bad luck and got so scared.

I freaked out and went to the hospital emergency department where i was prescribed a 28 days course of PEP which I completed.

3 weeks after the exposure I had some rash on my inner thighs and this was followed by nausea and vomiting some 1-2 days later which went away after 4 days.

At week 4 my right supraclavicular lymph node began to swell and it is still swollen up till now. I went for an HIV test and it came back negative.

At week 6 I noticed that my submandibular and parotid glands were swollen and freaked out again.

At week 8 I went back to the doctor and had another HIV test done. It was negative again.

At week 12 I repeated another HIV test and again it is negative.

All the tests were done using a combination test for P24antigen and 4th generation ELISA for HIV 1 & 2 antibodies.

I also had on/off night sweats from right after the exposure till around week 8, although not the drenching type. It is more like a layer of sweat on my chest and inner thighs. I dun recall having fever at any time.

My right supraclavicular lymph node and salivary glands are still swollen now after almost 2 months and this has gotten me really worried. My doctor did not find any other nodes elsewwhere.

My doctor insists that it is not likely due to HIV. He said that if the swellings were due to HIV, the tests would have shown it by now, given the highly sensitive nature of the tests. He also said that if the swellings were due to HIV, lots of HIV antibodies would have been produced and the test would have surely picked it up.

He does not want to run anymore HIV test and told me to just wait for one more test at the 6 months mark to 'dot the 'i's and cross the 't's' as per legal requirements and that he strongly believes even that test will be negative because almost nobody seroconverts between the 3 and 6 months mark.

He also said not to worry as there has been no reported cases of PEP failure in Australia and my risk from a single encounter is very low especially since the guy is on antiviral medication which would likely mean that his viral load is low. He said the swollen gland are likely due to other causes and that we should just monitor it and consider biopsy of the gland at the 6 months mark if they are still swollen.

As much as I would like to believe that I am HIV negative as per the test results, I am still unable to stop my anxiety and worries. I cant focus on my work and spend most of my time trying to reassure myself and then wondering if I am in denial. The swollen lymph node and salivary glands are still haunting me and spooking me out every second of the day.

I guess I would be better assured if I could get a second opinion here. My questions are

1) How long after symptoms appear would the test be positive? 2) Would it be possible to have all these symptoms and yet still be truly negative? Is it true that a swollen node due to HIV would surely show a positive HIV test? 3) What else could possibly cause all these symptoms, especially the swollen lymph node and salivary gland? 4) Is it true that with the p24 antigen/ 4th generation ELISA tests, it is extremely unlikely for anyone to test positive beyond the twelve weeks mark?

Response from Dr. Frascino

Hi,

I absolutely agree with your doctor!

1. The majority of HIV-positive folks test positive within four to six weeks after primary infection with the virus.

2. Yes, absolutely. If you were HIV infected, your tests would be positive by now.

3. There are literally thousands of medical conditions that are associated with swollen glands.

4. Yes.

Relax Mate. As they say downunder: she'll be apples!

Dr. Bob



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