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pep, lymph nodes
Oct 22, 2005

Hi Dr Conway,

I would be grateful if I could have your advice on this. I took PEP (started after 12 hrs) for about a fortnight after unprotected sex with a lady whom I lost track of. It's about 5 weeks after the exposure now and the glands in my neck are swollen up. they are slightly enlarged, soft, ache constantly and I have jaw ache and headache. I have sore throat since 2 weeks. The GP had a look and said that I have pharyngitis. There is no fever, no rash, no involvement of lymph node of any other part of the body. I have a tooth abscess that was treated with amoxicillin for 7 days ( finished 2 days ago). Please tell me

1. does every case of ARS have fever?

2. does involvement of one group of glands only i.e around jaw and neck rule out ARS? I mean is the gland involvement in ARS essentially generalised?

3. What test is best to have now for detection? should I wait for 6 months?

4. Is it so serious that I should visit a HIV consultant i.e is any kind of treatment indicated at this point of time if what i am having is ARS?

I live in a country where HIV consultants are rare. Your advice would help me decide what to do next. Thanks a lot.

Justin

Response from Dr. Conway

Dear Justin:

Not all cases of acute retroviral syndrome have fever or generalized lymphadenopathy. At this stage, if you are concerned, I would get a regular HIV antibody test (it may be positive at this stage) as well as a CD4 count and either HIV viral load or DNA PCR. It is likely that you do not have HIV, but your symptoms are suggestive enough that I would go ahead and do the testing to make sure.



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