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What are the symptoms of HIV?

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HIV AIDS Specialist
Practicing since : 1974
Answered : 1206 Questions
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Dr. XXXXXXX

I would kindly ask your opinion about the need of additional testing regarding my specific exposure…. Pls find below my potential exposure, symptoms, undergone tests and, finally, my questions...

Potential exposure:
- Deep kissing/ Fingering/ Unprotected oral (receiver)/ Unprotected vaginal with csw

Following symptoms:
- About 10 Days: Involuntary muscle contraction (mainly in lower legs/ cramps) + diarrhea
- About 14 Days: White tong/ dry mouth/ dry skin + diarrhea
- About 21 Days: Strange rash in my legs/ arms/ trunk/ neck (petechia like) + involuntary muscle contraction (mainly in lower legs) + diarrhea
- About 25 Days: Sore throat + mouth ulcers + night sweats for 03/04 days + joint pain + involuntary muscle contraction (whole body) -> went through medication (azithromycin)... no fever... probably due to medication...
- Up to now (16+ weeks): + white tong/ dry mouth/ dry skin over all body ( a lot dry) + involuntary muscle contraction (whole body) + intermittent diarrhea.

Undergone tests:
- 14+, 25+ days: Undetectable HIV-1 VL (cobas taqman roche 2.0)
- 04, 06, 08, 12 and 16 Weeks: Negative HIV 4th gen (same kit/ test)

Questions:
-     Are 12 weeks enough for being fully conclusive about a negative HIV-2 test despite many typical symptoms? I’ve never experienced such symptoms before….
-     Would you recommend additional testing for me?

Tks in advance for your support.
Posted Sun, 31 Aug 2014 in HIV and AIDS
 
 
Answered by Dr. S. Murugan 6 hours later
Brief Answer:
4th generation test ruled out HIV 1&2 beyond doubt

Detailed Answer:
Hi,
Welcome to HCM.
Thanks for posting your query.

First of all, earliest HIV manifestations can not occur before 4 weeks of the possible infection. But you had some symptoms (not very much specific to AIDS) started within 3 weeks. Those could unlikely be due to HIV.

Even though you had risks through your exposures, the 4th generation tests done after 12 and 16 weeks clearly ruled out the possibility of HIV beyond any doubt as 4th generation test is highly reliable test and detects both Antigen and antibodies against HIV 1 and 2. Unless you are on any immuno-suppressive drugs or had any ART for prophylaxis, I would not recommend any more tests for HIV.
All your symptoms must be due some condition other than HIV only. Moreover dry skin, white tongue, body pain and rashes and diarrhea can occur to anybody in absence of HIV due to other reasons.
So you consult your Physician and follow his advice and treatment, you will be alright. Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: What are the symptoms of HIV? 34 minutes later
Tks for your prompt response. I was not on art nor used immuno-suppressive drugs (except for 180mg of prednisone/ 60mg x 03 day treatment together with azithromicyn about 25 days after exposure).

My main concern here is about HIV-2... some say its window period is longer than hiv-1... I just want to make sure that 12/ 16 weeks is enough for hiv-2 abs to appear in a 4th gen hiv test despite risk and symptoms...

Since you have experience in dealing with HIV-2, I would like to hear your opinion about it.
 
 
Answered by Dr. S. Murugan 48 minutes later
Brief Answer:
4th generation test after 16 weeks conclusive.

Detailed Answer:
Hi,
Welcome back.

You had taken a short course of prednisolone which has an immunosuppressive action. Detection of HIV Antigen would not be affected by prednisolne. So with the 4th generation test, HIV 1 infection ruled out completely.
Regarding Antibody part, as you had taken Prednisolone we can not rule out a possibility of delay in appearance of antibodies against HIV, especially HIV 2, as it has to be ruled out only with the antibody part of the test after the window period. HIV 2 is a rare and slow progressive disease and transmission rate also is less compared to HIV 1, but there is not much difference in window period or the appearance of antibodies period. You had the last test after 16 weeks. So I feel that your result is final and need no further test as you had ruled out the delay in window period also. It is unlikely for you to have HIV 2 infection. Not to worry.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: What are the symptoms of HIV? 8 minutes later
Should I test again to rule out hiv-2?
 
 
Answered by Dr. S. Murugan 9 minutes later
Brief Answer:
Better to have one more test.

Detailed Answer:
Hi,
Welcome once again.

You can have one more antibody test after completion of 6 months and rule out once again for our mental satisfaction. Mostly not necessary.
Dr S.Murugan
Above answer was peer-reviewed by
 
Follow-up: What are the symptoms of HIV? 10 hours later
Added anxiety...

Doubts:
- Are Tylenol/ Nimesulid considered immuno-suppressive drugs?
- Could alcohol (beer, wine) ingestion delay ab response?
- In the meantime from now to the week 24th, would any additional medication delay ab response?
- Would you consider the results likely to change?
- Will the 24 weeks test be conclusive?

Tks again.
 
 
Answered by Dr. S. Murugan 4 hours later
Brief Answer:
No reports of sero-conversion after 24 weeks.

Detailed Answer:
Hi,
Welcome back to HCM.

=Tylenol and Nimusulid are not immuno suppressive drugs.
=Alcohol intake would not delay antibody response unless his liver had failed due to alcoholism.
=Prolonged course of immunosuppressive drugs may likely to confuse the antibody test. But usually we had not come such things after 24 weeks period in our practice or not reported in conferences or journal.
=The test done after 24 weeks is very much conclusive.
Dr S.Murugan


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