Question: Hi,

I just would like to know regarding HIV ARS Symtoms:

1. If in case Espongitis Candida occurs during ARS / Seroconversion time, would that go away on its own like other symptoms go away or considering its severity, one would need fungal treatment for that ?

2. I know HIV test is the Gold Standard. But, would a person's CBC / FBC / Blood work report show any abnormalities during "ARS / Seroconversion time" ?

3. Will only one ARS symptom last for more than 1 month, while other ARS Symptoms had gone in 10 days or so ? (If it was ARS at all!). In other words, will one ARS symptom would last for more than 20 days since the other symptoms had gone ?

My personal issue was:
I accidentally (Yes, really accidentally) "RECEIVED ORAL SEX" (Insertive oral sex) from a Russian Sex worker (Probably a high-class escort, but you never know their status!). No kisses or any other sexual activities were there. Just receiving oral sex (Her mouth to my genitals and it lasted for about 40 minutes!). I did not see any blood there. I saw only saliva, but honestly can not be sure at all. After 24 days of this incident, I felt something got stuck in my throat. Went to the Dr and he said it's GERD issue and gave me pills. The problem reduced the other day. However, I have never had a GERD problem in my life so far. I had no cough, cold, throat clearing etc etc.

Then I felt dizziness (I don't know whether it's due to the GERD pills he gave me). Then he prescribed Domperidon to control the dizziness. Further I saw my throat was severely red (a sore throat) and developed very low grade fever for about 2 days. Tongue was white in color which some people say tongue's reaction to the acid.

In 2-3 days dizziness gone. In 2 days the fever had gone. But, it took around 10 days for the "feeling something stuck in throat" feeling to go away slowly & slowly. Around 7-8 days for the tongue to come to normal color and feel tastes. Appetite also came back to normal after 10 days or so. BUT - STILL the 32nd day after these issues, still the red throat is there. I took an HIV Antibody Test (2 tests using the same blood) an Strip test and an ELISA test 33 DAYS AFTER the exposure and 7 DAYS AFTER the onset of these issues. Both tests came back negative. My FBC work showed normal.

Finally went to an ENT Dr and he inspected my throat by observation (no tests) and said it's called Laryngopharyngeal Reflux (LPR) which is called as "Silent Reflux" as well. That's why I did not have any heart burning effect. The acid had come up and that's why throat is damaged / burnt. Although his explanations made sense to me due to the following reasons:

1. I had a lump feeling in my throat and it got reduced the other day for GERD pills. If it was due to ARS HIV Candida etc, it's unlikely it get controls for GERD pills.

2. If it was ARS, then sore throat can not stay this long, while other symptoms had gone.

But, I am still clueless because, if it was Laryngopharyngeal Reflux (LPR), then why I had a low-grade fever for 2 days ?? Did dizziness really a side effect of GERD pills ?

Thus, I need an opinion of an HIV Specialist regarding my issue. Please be kind enough to provide your expert view on this.

Dear sir,

Loads of thanks that your answer relieved me a lot. Yes I was referring to Seroconversion illness.

My sore throat is still there (30+ days) while the other problems (Feeling in the throat, short-time Dizziness, short-time very mild fever, Loss of appetite and White coated tongue) had all gone away 3 weeks before. Based on this (that Seroconversion illness symptoms would go all at once, once the antibodies been formed), may I assume my problem might not be seroconversion illness sir ? (As sore throat still remains)

Further, may I also assume that, the feeling in throat was there only for one day in its severe format and the next day (after taking GERD pills), it got reduced. Then gradually it got reduced. Sir, could I assume, if in case this was Candial esophagitis, this is very short time period (a day or two) for the CD4 cells to rise and control Candial esophagitis ? So this might not be Candial esophagitis, Is this correct ?

I took the antibody test ELISA on the 7th day after the onset of these issues. If in case this was seroconversion illness, are there any chances the antibodies been detected in the ELISA and/or Strip test on this time sir ?

Again, many thanks for your time and special advice. In fact, I'm from your neighbour country and my mother tongue is Tamil. I feel glad to meet such a knowledgeable doctor here, as it's somewhat hard to find doctors in my country who have up to date knowledge about HIV. Your explanations make me feel comfortable. Thank you for that sir.

Thank you again for your comprehensive answer.

Sir, I was earlier prescribed Augmentin for sore throat, but it did not respond. The ENT Dr says the throat is burnt by the acid and that's why it's red in color. Is it acceptable sir ?

My heartiest thanks for your time. Feel comfortable to listen to you.

Dearest sir,

Thanks again for your patience and kind explanation. Satisfactory and understandable. Sir, may I ask only very few questions and then hopefully I would get satisfied.

1. Have you seen, read in medical literature or heard from your colleagues that someone infected with HIV through receiving oral sex once, but for about 40 minutes ?

2. Have you seen, read in medical literature or heard from your colleagues that a 5 week Antibody HIV NEGATIVE test result changed into Positive later on ?

3. My Full blood count done 33 days after the exposure was: WBC, Platelet count, Total Lymphocyte count and all were within the normal range except Eosinophils which my physician simply said it would increase if I had any allergies). Sir, If in case I had infected with HIV, would my this blood work done AFTER 33 DAYS of the exposure be normal ?

Kindly enlighten me on this sir. Thanks again for your patience. Very much of a help indeed.

Thank you for your answers sir.

Today I had an Strip rapid test (I think it should be 2nd Gen) and it came negative. I have requested an ELISA test of the same same sample again.

As per Dr. Hunter Handsfield - an award winning professor in STDs attached to the University of XXXXXXX as well as Dr. XXXXXXX Hook - "Best Doctors in the USA 2002 - 2006" awarded professor in STD attached to the XXXXXXX XXXXXXX Department of Medicine, USA which is one of the world's leading HIV/AIDS researching institutes, an "8 week antibody test (regardless of generation) is CONCLUSIVE & FINAL". In this manner, considering my low risk exposure and 9 week NEGATIVE Antibody Test, I rule out HIV. I believe, I should continue to work my ENT Doctor on any possible LPR Acidic reflux problems which keeps my throat red for more than a month now.

I believe you might have valuable things to add to this my view. Thank you for your time with me.

Dear Sir,

If you are happy with my views in the light of your highly experienced expertise, I would follow up with my ENT doctor for my throat issue and hopefully ruling out HIV. As I speak Tamil, I felt really comfortable with you and you were the main doctor I discussed my issues. You helped me a lot in the past month or so where I was really scared to death. I had never been this much afraid in my life. I was really mentally disturbed. You helped me a lot ease my anxiety giving your valuable views that my issues can not be HIV related. Specially, when I was down thinking my problem might be Candiasis, you scientifically proved it was not so - easing my mind. Thank you very much sir for all your assistance and helping in my hard time. I can not forget you. Following are quoted from Dr. XXXXXXX Hook. Thank you again sir.

I am pleased to hear that, as we expected, the test was negative. Any test obtained more than 8 weeks following a potential exposure to HIV provides definitive results. There is no need for further testing- the results you have are definitive. EWH XXXXXXX W Hook, MD,BS,Member of XXXXXXX STD Association, Member of XXXXXXX College of Physicians
Professor of Medicine and Epidemiology, Medical Director - STD Control Program, 2002-2006 - Best Doctors in XXXXXXX Infectious Diseases