What causes swollen lymph nodes on body 30 days post HIV exposure?

Posted on Thu, 18 Jun 2015 in HIV and AIDS
Question: Doctor , I m a male who had UNPROTECTED oral sex with a male , i took his penis in my mouth but he didnt ejaculate in my mouth . i have done it on
1st of APRIL and 19 th of APRIL
I have undergone
HIV antibody test on 22nd april
P24 antigen on 28 th april
HIV antibody on 2 may
HIV RNA PCR ON 5th MAY (15 days after 2nd exposure )
HIV DUO and P24 Ag on 15 may
HIV DUO on 21st MAY (30 days after second exposure)
i did not have any penetrative anal sex,
since 1st may i m having generalized lymph adenopathy , small swollen lymph nodes on neck , chest , armpits , thighs
all of them as of today would be less than 1cm in size .
apart from this my avg body temp is varying between 37.0 to 37.2 degree centigrade
my question is
1)Are my tests conclusive ??
2)After how many days of lymph node swelling will tests start working??
3)After how many days post infection lymph nodes swell ??
4) After how many days are RNA PCR results are conclusive
5)when should i go for testing again
6)what should be the further course of action
doctor please help me
every day i wake up and check my lymphnodes and find that a new one pops up every day . Doctor plz help me .
Answered by Dr. Vivek Chail 30 minutes later
Brief Answer:
Please find details below

Detailed Answer:
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

HIV is extremely rarely transmitted by oral receptive sex especially when there is no ejaculation.

1. Since you had p24 test on 15 May and last incident is on 19 April, therefore your tests are conclusive for HIV 1.

2. By the time lymphnode swelling appear, the tests usually become positive.

3. Lymphnodes might start swelling after two weeks in earliest of cases.

4. RNA PCR test is a viral load test and looks for amount of virus from 3 days to 4 weeks after an exposure.

5. The incidence of HIV 2 is very less and I dont think you should worry about HIV 2. However you can take a test for HIV 2 at 6 months for peace of mind.

6. Please get complete blood count done and consult a doctor to confirm the reason for your suspected lymph node enlargement. It is least likely to be HIV therefore there is no reason to get frightened.

7. Rapid fourth generation test which includes HIV 1 and 2 antibodies and p24 antigen is the best test for HIV is a reliable test. RNA PCR test is also reliable for ARS.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Vivek Chail 19 hours later
Thank you doctor,
Is my RNA PCR on 5th may not conclusive??
2)I went for a HIV 4th generation on 21 may (VIDAS HIV DUO P24 ag + antibody )
the result is non reactive can i consider it conclusive doctor .
3)IS there any chance of my result turning positive later after some time ?
doctor I M worried as my lymph nodes are growing big every day and many lymph nodes are swollen
i was on cefroxime for 10 days and no use .twice daily
as of now my lymph nodes on chest >2 cm size and on the abdomen
front and back of the thighs etc
and few but very small on the neck
4)doctor can it be a symptom of ARS ???
5)i read on the net that it could be lymphoma .
how many years will a lymphoma person live .
my doctor said that "let us wait for few weeks and see, it may subside by its own."
Doctor plz help am I dying ???
Doctor what is the probability that my Test results become positive??
21st was my last test and that is 4th generation and NON REACTIVE
and i have lost weight since 19 th april . there is no change in the diet habits,
guess all my symptoms are leading to ARS.

Answered by Dr. Vivek Chail 4 hours later
Brief Answer:
The fourth generation rapid test is almost confirmatory

Detailed Answer:
Thanks for writing back with an update.

1. Your RNA PCR on 5th May is almost conclusive.

2. The HIV 4th generation rapid HIV which is non reactive is conclusive for HIV 1.

3. There is almost no chance of you becoming HIV 1 positive. Extremely less chance of HIV 2 is only hypothetically present. Practically the chances are almost nil again.

4. Cefuroxime is an antibiotic and would have treated any bacterial infection should you have it.

5. ARS is less likely a possibility if your results are negative.

6. There are many conditions including lymphoma or chronic infections like tuberculosis and that is why your doctor wants to follow up closely with your symptoms.

7. Stress might cause your weight loss and other symptoms.

Please eat healthy foods and take a 2200 kcal diet and stay free from stress.

Hope your query is answered.
Do write back if you have any doubts.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Vivek Chail 36 hours later
DR. i have uploaded my qualitative PCR report which is done on 24th may .
can i take this is as conclusion or any further more tests are required ??
2) The test did not mention any thing about lower limit of detection .
3)how different is RNA PCR from DNA PCR ??
5)kindly check my report and guide me if any further testing is required.
Answered by Dr. Vivek Chail 10 hours later
Brief Answer:
RNA PCR and DNA PCR are similarly reliable

Detailed Answer:
Thanks for writing back with an update.

1. This is a almost conclusive report for HIV1. In practice p24 is the best test for you at 30 days and that is also negative therefore your reports are conclusive for HIV1.

2. The test is a qualitative test. It will show whether HIV virus RNA is present in your blood sample or not. It will not tell the quantity.

3. RNA is found in the virus and DNA is found in the cell infected by virus. RNA PCR evaluates the presence of HIV RNA in the virus and DNA PCR will look for HIV DNA in the cells. The HIV has RNA when outside the cell and once it enters the cell then it makes copies of DNA.

4. DNA PCR and RNA PCR have similar reliability.

5. You do not require any more test right now. For peace of mind you can get HIV1 and 2 with p24 test done after 6 months from date of second incident.

Hope your query is answered.
Do write back if you have any doubts.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Answered by
Dr. Vivek Chail


Practicing since :2002

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