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An_192508 posted:
Hello,

If I am infected by HIV and am suffering from ARS (the symptoms of acute primary HIV infection syndrome), what is the timing of the symptoms. How soon after infection do the flu-like symptoms (fever, sore throat, chills, swollen lymph nodes) and how long do those last? How soon after infection does the rash appear and how long does it last? Do the rash and flu-like symptoms occur simultaneously or in succession (and in what order)? If I am tested for HIV antibodies during the acute infection period, how likely is a false negative? How long after infection in an RNA antigen test likely to provide accurate results? Can you describe the rash that often occurs during acute HIV ARS? What are some characteristics of this rash that distinguish it from other rashes? Please help and thank you.
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Nieciedo responded:
It is not generally helpful to describe HIV symptoms.

For starters, not everyone experiences symptoms and those who do experience them do not do so to the same degree, Moreover, the symptoms of Acute Retroviral Syndrome are indistinguishable from the flu and numerous other much more common illnesses.

HIV symptoms are quite bluntly useless for diagnosis and misleading, and it's not worth your time or mental energy to worry about them.

If symptoms are going to appear, they will do so 2-6 weeks after infection and will last about a week or two and then go away, just like the flu.

The only reliable guide to whether you may have been exposed to HIV is to assess your behavior. If you have had unprotected anal or vaginal sex with a person of unknown or positive status or if you have shared IV needles with a person of unknown or positive status, then you may have been exposed and you should get tested at 90 days after the risky encounter. A test at 90 days or later will give you an accurate and conclusive result. A test as early as 30 days will give you an excellent indication of your status which may give you some peace of mind.

Dan
 
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David J Malebranche, MD, MPH responded:
Good evening,

Just to piggy back on what Dan already answered:

1. 2-6 weeks in general rule of acute HIV symptoms after exposure
2. The rash and/or other symptoms last a week or so after exposure
3. I can't give you a definitive number on how often HIV antibodies are negative during acute infection. That is individual and depends on many factors affecting one's immune system.
4. If you are having flu-like symptoms that ARE DUE to acute HIV infection, the viral load will be high during these symptoms, and usually happen as early as 1-2 weeks after exposure if the infection establishes itself.
5. The rash that occurs in acute HIV is one that is red and either flat and/or bumpy, and usually occurs on the chest and trunk. It is important to note that although this rash is one of the 3 primary symptoms that occur during acute HIV infection, there are many people that don't have any symptoms at all when they are infected. That's why its not always reliable to worry that every rash is HIV related, but just have a healthy suspicion to check it out if it happens 2-6 weeks after a risky sexual encounter (meaning unprotected anal or vaginal sex).

Hope that information helps... sorry to be wordy but wanted to be clear..

David
 
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stresstime replied to David J Malebranche, MD, MPH's response:
Dr.

i had asked a question on another matter. i was masterbated by a sex worker with the same hand as the hand she had masterbated herself. She wiped me off with the tissue she wiped her hand with after i was finish. a day after my exposue my girlfriend developed a rash on her face that went away in 3-4 days. a week later she developed a small rash looked like a flat iron burn. 3 weeks later after exposure i am having a headache and some facial flushing. Gail said i had no risk but i am scarred to death. please help
 
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David J Malebranche, MD, MPH replied to stresstime's response:
Hello,

there is absolutely no risk from this potential exposure. I would have your girlfriend go see a medical provider who can look at the rash, as it is likely something else. Sounds like you may have a little bit of guilt over the sex worker episode - her rash could be anything from an allergy, and your symptoms (headache and facial flushing) also could be anything. Have someone take a look at it and see what they think. Good luck!

David
 
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stresstime replied to David J Malebranche, MD, MPH's response:
thank you much for your response. All of you do great work helping those with serious questions.
 
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stresstime replied to David J Malebranche, MD, MPH's response:
dr. now this week, headache and ache in the back of my neck. I am having upper stomach pains. no fever. continued facial flushing, all symptoms seem to go away at night and begin at about noon each day. i did call cdc and they told me exposure was real. Went from headache week three to feeling ok until week six. Even though i have not felt great since week three nothing like now. it has been six weeks since my exposure and am suffering until the 3 month period. i am worried to death. i know you have already answered but need some more reassurance to help for the next 6 weeks. thanks.
 
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georgiagail replied to stresstime's response:
What the CDC told you was incorrect (and frankly, I find it hard to believe that they told you this exposure was "real").

Reread what Dr. Malebranche wrote.

Gail
 
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stresstime replied to georgiagail's response:
Gail, the disucssion i has was with one of the cdc hotlines. the lady i talked to said she did not answer calls but worked in the clinic. she said that my exposure since i might have some contact with vaginal fluids was a high risk and suggested that i go to a clinic right away. scared me to death. i know how frustrating continued questions after you have answered them. not sure how many that ask questions turn out to be negative, but if everyone's as stressed as i am the words you provide give all of us comfort. Long way of saying that is who i talked to. i am sure not near as exspert as Dr. Melebranche. Wow you are working this holiday. any kind words would be appreciated
 
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stresstime replied to stresstime's response:
gail,

each time i hear from you guys, i feel better. how is that for stress related symptoms. one more response from you and i will not bother you again
 
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georgiagail replied to stresstime's response:
The lady at the CDC was incorrect with what she told you (heck; on a less serious note, I wonder if the phone got answered by the cleaning lady!).

As Dr. Malebranche previously wrote, he sees absolutely no risk from this event. I tend to agree with his statement that you may be overly focusing on what you believe may be HIV symptoms because of some guilt over visiting this sex worker. Remember how concerned you initially were that this event left you infected and thus infected your girlfriend.

Keep in mind that while HIV is frightening to many people it is actually a pretty difficult disease to "catch". IF you had had unprotected intercourse (or shared IV drug needles) with this sex worker we'd be a bit more concerned about the risk of exposure. However, the experience you underwent did NOT put you at risk at all. Really.

If you wish, you can always considered getting tested now (such a screening test would be between 95 and 99.9 percent accurate in terms of your status), then retested at 90 days. That nice big NON-REACTIVE (i.e., NEGATIVE) test result may go far in putting your concerns behind you.

Gail
 
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stresstime replied to georgiagail's response:
Gail,

thanks for the time you took to answer my question (s). After your previous response I began to wonder who had answer the call i made to the hot line. maybe it was the cleaning lady (very funny). thanks guilt and stress are powerful emotions. i have learned my lesson.

thanks again.
 
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stresstime replied to David J Malebranche, MD, MPH's response:
Dr.

Altough i had promised Gail i would not ask anymore questions, i do have one additional. is the reason you said there is no risk because of the fact the HIV virus does not survive in the air outside the host. Or was it the fact that there was little chance of the virus entering my blood stream. i have read many similar questions but have not seen an answer to this question. another reason is that here 8 weeks after my encounter i have a sore throat, a swollen lymph node (visible ball on my chin which i haven't been touching, sore neck. i would appreciate your response to last me until the 90 day window for testing.

thank you.
 
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Nieciedo replied to stresstime's response:
There was really no way for the virus (assuming it was even present in the first place) to access your blood stream. That's why you weren't at risk.

Your symptoms also do not match up with what people who become infected with HIV experience.

Dan
 
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stresstime replied to Nieciedo's response:
Dan,

thanks for your response. The reason for my question is that i have a slight what has appeared to be a pimple from an old herpes outbreak. it has been there for years and breaks open on occasion. no bleeding but broken skin. not sure if this would change your response. So i was hoping that Dr. David would reference the CDC study about the live of hiv outside the host. 10 weeks after exposure i have stomach pains and chills. my girlfriend also has chills.

thanks for all you do for all of us posters


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