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HIV-2 and maybe other rare strains
Nov 15, 2010

I had unprotected sex with a woman who claimed she was tested and HIV free (she never left the US, or the NC city she lives in for that matter). Afterwards I noticed an abrasion on my penis, so I would imagine this as a high risk as an exposure gets.

Since then my symptoms have been textbook ARS: swollen left cervical lymph node from day 20 on to now (day 60). Constant night sweats. Sporadic swelling of other nodes which subside quickly. Occasional joint pain.

I had negative Home Access at Day 28, negative HIV-1 AB and HIV-1 PCR at day 50, and negative HIV 1/2/O AB at Day 56. In theory with those results I'm close to WOOHOOland, but given the exposure and ongoing symptoms I'm petrified. I just ordered an HIV-2 PCR which will take 10 days.

Frankly I'm pretty convinced this will have a bad ending, but regardless I wanted to get your thoughts on this situation. Particularly troubling to me is that while all the literature you can read says HIV-2 is rare in the US there are virtually no current stats (although after countless hours of searching there was a recent blurb that New York City did a retrospective surveillance from 2000-2008 and found 62 confirmed or suspected HIV-2 diagnoses, 60 with West African ties. But I also saw another forum where someone claiming to be a nurse in San Francisco potsted that 10% of her new cases are HIV-2 now.

Would greatly appreciate any comment on my situation and the overall topic of risk when HIV-1 tests are negative.

And of course if my situation ends badly as I believe it will, I will send along the blow by blow to hopefully help others.

Response from Dr. Frascino

Hello,

No doubt unprotected sex is an unwise decision and places you at some degree of risk for STDs, including HIV.

Your "symptoms," despite what you read, are far from "textbook." Your repeatedly negative HIV tests out to day 56 are very encouraging, but not yet conclusive. For that you will need to wait until the three-month mark.

Even though you are "pretty convinced this will have a bad ending," I'm very convinced otherwise. HIV-2 testing was not warranted and the result will undoubtedly be negative. The information from "someone claiming to be a nurse in San Francisco" is pure poppycock. The retrospective surveillance data through 2008 is correct, as is the information linking HIV-2 very strongly to West Africa where HIV-2 is endemic. You can read more about HIV-2 in the archives of this forum, if you remain curious.

Good luck.

Dr. Bob



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