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A little more clarity to the always unclear ARS
Jul 31, 2010

Hi Dr. Bob,

It has been a real pleasure (albeit under a difficult circumstance) to learn about your work and foundation. And, I will be making a donation - not to elicit a response - but because of how immediately tangible HIV becomes when one considers themselves at risk.

36 days ago I had unprotected vaginal sex with a friend of mine. To my knowledge, she does not seem particularly high risk. I have looked at your previous answers and have not been able to find the precise answers to my questions. I hope they are not repetitive and could be helpful to others.

1. Does tiredness in the legs equate to myalgia? Or, is myalgia generally thought to be an aching pain when present?

2. Where does fatigue fit in on the spectrum of ARS symptoms? Is it thought to be a by-product of other symptoms or is it able to occur on its own as a sole symptom?

3. Is an ARS rash almost always maculopapular and bilateral when it presents? As in, is it one of those things that you would know when you see it? Or, can it be more subtle (e.g. a small patch of redness, white bumps, etc.)

4. I have read that most people who present symptoms will have a fever (96%). Is this figure accepted within the medical community or simply the result of one study?

5. My current situation notwithstanding, what would be the likelihood of a person contracting HIV 15 years ago without showing any signs or taking medication? Fortunately, I always used condoms before this latest exposure but this long-past incident now has me wondering.

6. Finally, do you know any research studies off-hand that might be helpful to those looking for information on ARS?

Thanks for all your great work

Response from Dr. Frascino

Hi,

1. Nope. Myalgia refers to pain, not "tiredness."

2. Fatigue is very nonspecific. It can be associated with HIV (see the Fatigue and Anemia expert forum) or with many other conditions, ranging from anemia to anxiety/depression.

3. Yes. Yes. No.

4. Fever is very common with HIV ARS. It's accepted within the medical community and has been verified in clinical studies.

5. Extremely unlikely. Your worries are unwarranted and could be put permanently to rest with a simple rapid HIV test. You would be WOO-HOO-ing in as few as 20 minutes. Testing is not medically warranted, but might help for psychological peace of mind.

6. Not really. We already know what we need to know about ARS. Symptoms are notoriously unreliable, as ARS symptoms are not specific for HIV disease. The bottom line is that if you've placed yourself at risk for HIV, get HIV tested outside the window period, whether or not you have any symptoms. It really is just that straightforward.

Thanks for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated and urgently needed.

Be well. Stay well.

Dr. Bob



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