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supposedly low risk exposure but frightening symptoms
May 23, 2010

Hi Bob,

Let me start by saying I greatly admire your work and will be sending a donation. This stressful episode has really increased my awareness of this illness (hopefully not too late).

6 weeks ago I performed oral sex (cunnilingus) on a girl I wouldn't typically describe as low risk, since she's from an eastern european country with a known HIV epidemic (not africa, but not the USA either). There was no vaginal sex or other exposure. I woke up the next day and got extremely worried, but some quick internet research calmed me down since most experts seemed to think the risk of HIV transmission through cunnilingus is low to the point of being negligable.

Three days later I developed some mild flu like sypmtoms, no nasal congestion but a sore throat. Nothing unusual and hopefully early for ARS, but then 10 days post exposure the lymph nodes either side of my neck became swollen. This was recently verified by a Dr, and they remain swollen now which makes 5 weeks of swollen nodes.

After the initial swelling either side of my neck I developed definite symptoms of a viral infection. My throat would become inflamed and sore at times and these sensations would seem to effect different areas more severly at different times. ie when I woke it would be relatively calm, then the area near my glands would swell and feel congested, the swelling would move down either side of my neck, and often the area behind my right ear below the base of the skull would swell. This continued for about 3 weeks and although the sore throat is gone, the nodes are still a bit swollen. I'm pretty sure I've noticed a swelling senasation below the armpits as well.

I haven't experienced fever, diahorea, or weight loss. My skin became a bit sensitive at about the 3 week mark and at times it felt like there was a burning sensation around my lower abdominom. At week 4-5 I thought I noticed a suttle rash around the top of my stomach and inner chest, although this is not too visible.

The Dr I went to see ruled out EBV/mono since my tonsils looked fine, and I've never experienced fatigue or fever. They also put me on a 5 day course of tamiflu which hasn't cleared it.

Some people have tried to reassure me that it may be a "garden variety" virus, but the length I've had these symptoms for concerns me. I don't often get swollen lymph nodes at all.

1) should I be as worried as I am about these symptoms given my encounter? 2) could there really be a more probably explanation considering how long I've had them? I mean, don't most viral infections dissapate after no more then 2 weeks? 3) do they sound typical of ARS. I've made the mistake of reading the internet a lot, and from what I can tell, they do.

I would greatly appreciate your opinion and will definitly make a good donation.

Thanks

Response from Dr. Frascino

Hi,

I agree cunnilingus carries a very low HIV-transmission risk. I also agree three days would be very early for HIV ARS symptoms to manifest. I further agree it's a mistake to search the Internet for symptoms and then self diagnose!

1. Nope. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. The only thing to worry about is HIV-acquisition risk. Yours was extremely low.

2. Yep. There could indeed be a number of reasons for your symptoms. And yes, most (but not all) common viral infections resolve within two weeks.

3. Nope.

Thank you for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's very much appreciated. In return I'm sending you my good-luck karma that you are now and will always be HIV free!

Good luck. Be well.

Dr. Bob



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