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time before symptoms develop

May 28, 1997

Dear Mr. Sowadsky, It sounds like I may have a classic case of acute HIV infection. About 65 hours after a risky heterosexual encounter with a woman whom I've since learned is promiscuous, I developed a slight sore throat, followed by a fever, a very sore throat, and swollen glands (which lasted about 4-5 days). My only comfort has been the fact that you and others have reported that showing symptoms this soon after the encounter is unlikely. Much to my dismay, however, I found a book by David H. Spach and Thomas M. Hooter (THE HIV MANUAL: A GUIDE TO DIAGNOSIS AND TREATMENT, 1996), in which it is asserted that the lower end of the range is only three days and the MEDIAN IS ONLY 5 DAYS!!! This is contradicted by other sources (e.g. Seth C. Kalichman in ANSWERING YOUR QUESTIONS ABOUT AIDS, 1996, who claims that there has been nothing reported at less than a week); nonetheless it seems to confirm my worst fears. Can you make any sense of this confusion? I know that only testing can confirm for certain, but I am nearly convinced. I have a doctor's appointment, but I don't expect to hear anything new. I've already had mono before, I had no other symptoms (besides swollen glands and fever) that would indicate a flu, and a throat culture was negative. I am distraught and paralyzed by despair, and will be for a long time, I'm sure. Thank you.

Response from Mr. Sowadsky

Hi. Thank you for your question. I have had a lot of people come to me concerned about Acute Viral Syndrome, and exactly when it occurs. Can it happen in the first hour after an exposure? The first day? The first week? The first month? The first year?

Because the symptoms of Acute Viral Syndrome are so general and non-specific, it's difficult for anybody to determine the exact time that this syndrome occurs. The fact is, nobody can give you an exact time, since it can vary from person to person. Also remember that during this time, a person may or may not test positive on the test. This makes it even more difficult to determine if symptoms are related to Acute Viral Syndrome or not. All anybody can say is that the symptoms occur within the first month or so (that is, within the first 4-6 weeks) after infection. The symptoms usually last for a week or two, although this, too, can vary from person to person. They do not however last for many weeks or months. And these symptoms do not occur in all people; the estimate is about 70% of people get this syndrome. That's all anybody can say.

Whenever you get any symptoms after an exposure is unimportant and irrelevant. What is important is that if you've been exposed to the virus, that you get tested, regardless of whether you have symptoms or not. And if your symptoms are persistent or very severe, it's important that you see a physician, regardless of what you think the cause may be.

For more information about symptoms, read the VERY IMPORTANT message, "A MESSAGE FROM RICK SOWADSKY ABOUT SYMPTOM QUESTIONS".

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).

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