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Could penis pimples,groin pain and armpit pain indicate possible HIV even if HIV test results come negative?

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HIV AIDS Specialist
Practicing since : 1974
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Sir, Last month(29 Sept 2013) i had sex with a call girl whose hiv status i am not aware of. I inserted my finger on her vagina for almost 2-3 minutes,but i am not sure whether i had a cut or not in my finger.Visibly it was not there as per my notice.but might have an opening in between the nail which was not bleeding.I have kissed her vagina with my lips which had a crack and not bleeding.I did not use my tongue at all.I I used condoms during vaginal intercourse.After this encounter i was so scared and stressed for 2-3 days.On the fourth day(3rd oct 2013) i got symptoms of fever (especially at night) with joint weakness,fatigue and shivering.I already had mouth ulcers because i was using some fibrous dental wear for past few days.I went to Dr and he asked me to get admitted.He ran all the tests for malaria and widal test which all came negative.But my total bilirubin level was 1.48mg/dl and indirect bilirubin was 1.40mg/dl.All other blood counts were normal.The wbc count was9270/ul and neutrophils were 71%, lymph 23% ,mono-5%,Eosno-1% during the first day of hospitalisation.The x ray of chest and sonography reports were normal.Exceptthe radiologist suggested in report as "hypoechoic echostructure of liver suggested clinico pathological correlation" . i was hospitalised for 6 days and i was severely stressed and could not sleep properly.The nurse took the temperature which was normal but i felt excessive heat whenever i sleep.I got burning sensation in penis,the urine report showed 1-2/hpf pus cells and epithelial cells were occasional and he prescribed cital syrup.I felt the entire episode of fever like acute hiv symptoms.i got discharged on 11th oct 2013 but sometimes i felt feverish and nausea.i took rest for one week but i was under severe stress and whenever i take food i felt problem in swallowing and the mouth ulcers still remained.Now from 23rd oct i felt like a red sore/wound(2 red pimple like very small) like on the XXXXXXX of my penis near the urinal opening.It is making me uncomfortable.Now i have mild flow of mucous from nose to throat and always felt like coughing but no coughing were experienced except some mucous flow in throat.i am severely stressed now and i have made in my mind that i am infected with hiv .i could not sleep or concentrate At 31 st day of possible exposure at XXXXXXX hospital, Chennai i have done 1)Anti HIV 1&2[Ag/Ab] third generation -Non reactive 2)p24 Antigen by CMIA - non reactive 3)VDRL which is also nonreactive 4)HBSAG by CMIA ,Anti HCV by CMIA,Anti HAV IGM which were all nonreactive At 41st day i have done HIV rapid test which gave result in half an hour which is non reactive But i experienced all the symptoms like recurring penis pimples, Postrate infection with groin pain,Armpit pain(not continuous but sometimes) ,mucus flow thru throat etc, but no temperature At 62nd day i have done an Elisa at Chennai lab which also came negative At 62nd day the WBC count seems to be 6300cells compared to 9270cells in the previous month now also i feel slight throat infection, penis pimples,groin pain(not continuos but recurrent),sometimes i feel very tired etc Is it a clear case of HIV? How reliable is 62nd day ELISA test ? Thank you
Posted Mon, 6 Jan 2014 in HIV and AIDS
Answered by Dr. S. Murugan 1 hour later
Brief Answer: HIV free.Risk negligible.Rapid test after 90 days Detailed Answer: Hi XXXX, Welcome to XXXXXXX Thank you for posting your query. First of all, don't get upset. You are HIV free. The earliest HIV manifestations of acute infection will appear only after 4 weeks after the possible infection. You had started to develop your manifestations 3 days after the encounter. So it could not be due to HIV. It could be due to ordinary bacterial or viral infection that anybody can have and not related to HIV. Your urine and blood investigations were within normal limits except that of the slight bilirubin rise. This could be a spell of non venereal Hepatitis A and you are getting recovered. The negative HIV1&2 (Ag/Ab) Combo 3 rd generation test done on 31 st day of your high risk activity ruled out the possibility of HIV1 and it is more reliable and conclusive. The Elisa and Rapid test are conclusive only after 12 weeks not earlier than that. You had a protected vaginal contact. Fingering and kissing the genital carries a negligible risk for HIV as per CDC,Atlanta. So you need not worry about HIV. My suggestion is to go for one more HIV rapid test after three months to rule out the possibility of HIV2 which is a very rare possibility (0.3%). Antibodies against appears only after 8-12 weeks of the possible infection. The third generation Combo though it is able to pick up both antigen and antibody, at 31st day as antibody was not there it can rule out P24 antigen for HIV1. So a rapid test after 3 months can rule out everything conclusively. Dr S XXXXXXX
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Follow-up: Could penis pimples,groin pain and armpit pain indicate possible HIV even if HIV test results come negative? 17 hours later
Sir, But i Anti HAV report is negative for hepatitis as mentioned in the earlier question 1)Then it could not be Hepatitis right? 2)Will the mentioned medication like tab oflox,Montec LC,moxikind CV 625 and SN 15 affect the seroconversion /window period for detection of HIV? 3)i have seen in some article that some chemotheraputic drugs and hepatitis infection delay window period (till six months) and tab oflox is stated as chemotheraputic drug in its details.Will these antibiotic affect the seroconversion/Window period? 4)What could be the possible reason for WBC count decrease from 9270 cells to 6300cell within past one month? 5)will the swollen lymph nodes near the neck,armpit and pain in the groin an indication to worry? please help to clarify these thank you XXXX
Answered by Dr. S. Murugan 44 minutes later
Brief Answer: Hepatitis possible. Ofloxacin not chemotherapeutic Detailed Answer: Hi, Welcome back. Very interesting questions and pleased to answer. 1. Hepatitis A, like HIV, in very early stage before the appearance of antibodies (8 weeks) the test might give a negative result. So there is a possibility of Hepatitis. 2&3. Any of these drugs used by you would not delay the appearance of HIV antibodies. Ofloxacin is not a chemotherapeutic agent. The chemotherapeutic agents that can delay the appearance of HIV antibodies are anti- cancer drugs and they are usually called as chemotherapeutic agents. 4. Variation in WBC count time to time occur in our body due to various other conditions of stress, infections etc. Your both count are well within normal limits. 5. Swollen lymph nodes can occur to anybody without HIV also due to various other reasons. I hope you got answers for your queries and if you have any more questions I will be pleased to answer. Dr S.Murugan
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Follow-up: Could penis pimples,groin pain and armpit pain indicate possible HIV even if HIV test results come negative? 4 hours later
Sir, 1) Will hepatitis infection delay the window period? 2) i experience swollen lymph node at neck and someother regions, my groin and lower abdomen are paining.Will there be any any other STI infections ? 3)What all tests do u suggest to check the other STI infections? Thank you
Answered by Dr. S. Murugan 25 minutes later
Brief Answer: No delay with STD/HIV Detailed Answer: Hi, Welcome once again. 1. There is nothing like that Hepatitis interfere with the formation of antibodies and delay the window period. It is not so. 2. Only two sexually transmitted diseases manifest with generalized symptoms. One is HIV and another is Syphilis. Both these possibilities are rare as far as fingering and kissing the genitals. If it is due to syphilis, early manifestation will occur as ulcer over finger or over lip along with adjacent lymph node enlargement. Generalized manifestation in Syphilis will take 6 months or more to manifest. HIV also multi-group lymph node enlargement will take place after 6 months to one year a not earlier. It cannot manifest a generalized lymph node enlargement within a period of one month. There may be some other causes for the lymph node enlargement which could be identified with examination and appropriate investigations and treatment according to the outcome of the results. Your physician will guide you properly you need not worry about STD and HIV. Dr S XXXXXXX
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Follow-up: Could penis pimples,groin pain and armpit pain indicate possible HIV even if HIV test results come negative? 10 days later
Sir, I am getting lower back pain,fatigue My lymph node on the right groin,lower back,armpit and left neck are swelling Always have nausea sometimes my penis tip is itching and penis pimples are recurring i have groin pain also During sleep i feel very chill and increased heartbeat i am really worried thank you
Answered by Dr. S. Murugan 3 hours later
Brief Answer: HIV1,Syphilis ruled out.Look for other causes. Detailed Answer: Hi XXXXXXX Welcome back. There are hundreds of reasons for lymph node enlargement and fatigue other than HIV. As you are having lymph node enlargement you need further investigations like Fine needle aspiration biopsy or an excision lymph nodal biopsy to find out the cause. Itching over the tip of of penis also due to various other causes. Yeast infection, Genital Herpes,Prostitis, Non-Gonococal urethritis have to be ruled out with appropriate investigations. Feeling of chillness and increased in heart beat may even be due to the anxiety and phobia of STD. If you meet your physician, he/she will guide you and fix your problem and treat the same. HIV-1 infection which is most common in our country had already been ruled out in your case as well as Syphilis. HIV-2, a rarest possibility has to ruled out still but unlikely to be due to fingering and kissing. Trust your results and your physician you will be alright soon. Dr S.Murugan
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Follow-up: Could penis pimples,groin pain and armpit pain indicate possible HIV even if HIV test results come negative? 2 days later
Sir, Whom should i go for, A general physician or a urologist? Currently under medication (4th week)for prostrate infection with oflox tab and Alfoo tab Still my groin pains,armpit pains thank you XXXX
Answered by Dr. S. Murugan 3 hours later
Brief Answer: Consult a physician and follow his advice. Detailed Answer: Hi, Welcome back. As you have generalized lymph nodal enlargement, it is better to consult a physician rather than an Urologist. He/she will examine you and investigate and treat you or guide you appropriately. Dr S.Murugan
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