Q. I am at the risk of HIV AIDS. Please help.

Answered by
Dr. Sidharth Sonthalia
and medically reviewed by iCliniq medical review team.
Published on Nov 18, 2017 and last reviewed on: Oct 05, 2019

Hi,

I am a 31 year old male. About 38 days before I had sex with a CSW (Commercial Social Worker). It was protected vaginal sex and protected oral sex. Also there were deep throat kisses which lasted almost a minute. I am not sure if the condom was torn during the intercourse. 

Since last 3 weeks I have sore throat and mild joint pain. No real fever. Sometimes during afternoon time, my body temperature raises up to 37.2 degrees centigrade. The sore throat was mild but was a one pin point like feeling. The phlegm had blood stains. Phlegm was green or yellow in color. 

I went to the doctor and he checked chest x-ray and found no problem. I tested HIV 3rd Generation antibody test after 19 days of exposure, which was negative.

My questions:

  1. Are my symptoms related to Acute Retroviral Syndrome (ARS)?
  2. Is there any possibility for transmission of HIV through deep kissing?
  3. What can be the cause for blood stained phlegm?
  4. An ENT specialist had told me that the partition of my nose is a little bent. Is there any relation of this and my symptoms?
  5. I am feeling a little weak but I think this is mostly because of anxiety.
  6. How accurate is my 19 days HIV test result?
  7. Can sore throat without fever can be a symptom of ARS? I have only sore throat and very mild joint and muscle pain and that too not constant.

Dr. Sidharth Sonthalia

Cosmetology Dermatology HIV/AIDS Specialist Hair Transplant Surgeon Venereology
#

Hi,

Welcome to icliniq.com.

Based upon your history, my answer to your questions:

1. Are My Symptoms Related to ARS?

Acute Retroviral Syndrome (ARS) typically begins 7-14 days after the exposure to a HIV positive patient, and may last for up to 3-4 months. The symptoms are typically "flu-like" with fever (may be high grade or low grade), fatigue, headache, aching muscles or joints, sore throat, swollen lymph glands and sometimes a maculopapular rash.

Now, this is simply a description of ARS, this does not prove that you have it!!!!! Let me dissect this issue a little closely for you:a) The failure rate of condoms may be up to 5%, and since you are not sure of it being torn, there is a definite likelihood that it may have ruptured.

However that still does not ensure you acquiring the infection. Because HIV acquisition has so many issues - the CSW in question should be positive and more likely to spread it if she had symptomatic AIDS with high viral titres. Thus, there is no way of accurately assessing your risk of acquisition of the infection. I would recommend that instead of teasing your mind about "YES" or "NO", get the tests done (mentioned below) to get over your anxiety.b)

Though your symptoms are similar to ARS, by all means these are also the symptoms of the following diseases. So, unless we get the tests done, we may not be sure. There are other STDs (Sexually Transmitted Diseases) related, that have a similar clinical picture . "Herpetic gingivostomatitis and pharyngitis" (caused by Herpes Simplex Virus, a sexually transmittable disease), and rarely "gonococcal pharyngitis" (another STD, in which urethral pus filled discharge is additionally, but not always seen along with sore throat).

The third possiblity is of course a "normal viral fever" caused by simple viruses like adenovirus, coronaviruses etc., which may transmit from anyone to anyone, simply due to kissing. Let us hope you have the last type of fever that subsides without any complications.Your picture is non-specific and does not suggest any infection related condition.

2. Is There Any Possibility for Transmission of HIV Through Deep Kissing?

Kissing per se is not known to transmit HIV, except for few doubtful cases reported in medical literature. Of course "deep throat kissing" may have a little higher risk. The possibility will depend on the HIV status of the CSW.

3. What Can be the Cause For Blood Stained Phlegm?

If you have been trying to clear your throat vigorously to get rid of the phlegm, the severe blows on the throat may also lead to mildly blood-tinged sputum. The other cause may be Pneumocystis jiroveci pneumonia, commonly seen in patients with HIV-AIDS. However, it is just a rare possibility.

4. An ENT specialist had told me that the partition of my nose is a little bent. Is there any relation of this and my symptoms?

ENT specialist may have diagnosed DNS (Deviated Nasal Septum). It might be a cause for recurrent sinusitis and occasional epistaxis (bleeding from the nose), none of which is your primary symptom. So it seems to be totally unrelated.

5. I am feeling a little weak but I think this is mostly because of anxiety.

Weakness may be a part of the viral fever which you have, with additional component of anxiety induced lethargy. No harm in taking Giloy Amla Juice twice a day (10 ml) and tablet Septilin twice a day for a month. Get your Complete Blood Count (CBC) and Liver Function Test (LFT) done. In addition get serological tests for hepatitis B and hepatitis C done. Very few people know that the possibility of transmission of these infections along with or even without HIV is decently high in sexual encounters.

6. How accurate is my 19 days HIV test result?

It takes up to 12-16 weeks for HIV antibodies to become detectable by ELISA test. Thus your HIV ELISA test, though being accurate (depending on the lab you got it done), is still not an indication. It simply suggests that you are not "seropositive" for HIV at present. A repeat test of HIV ELISA, 3 months after the day of intercourse and then once again at the 6th month is the standard practice of confirming or ruling it out.

However, in today's era we have early diagnosing blood tests which may detect HIV infection even before ELISA turns positive. These tests include:

  • a) Positive HIV-1 RNA level by PCR (Polymerase Chain Reaction) technique (more than 50,000 copies per mL) in the absence of a positive ELISA. It is 95 to 98 percent sensitive for HIV and becomes positive within 11 days of infection. During the symptomatic phase of acute HIV infection, the viral RNA shows in excess of 50,000 copies per mL, though the levels may fall over next few days.
  • b) Detection of "p24 antigen" in serum or plasma.
  • c) Western Blot test.

So I will advise you to get the above tests done to have the peace of your mind.If at all (God forbid!), your report for ARS comes positive, there are Highly Active Antiretroviral Therapies (HAART) available, which may be started soon after the tests detect the infection.

The details of that may be discussed in our next consultation once I have your reports. But do not lose hope, because modern medicine is capable of salvaging your condition (and all this is based on the premise of you having ARS, which has not even been proven!!!).

7. Can sore throat without fever can be a symptom of ARS? I have only sore throat and very mild joint and muscle pain and that too not constant.

I have answered this query for you in the discussion above.

The Final List of Tests to be Done:

1) For HIV-ARS:

  • PCR for HIV-RNA levels (>50,000 copies/mL),
  • p24 antigen assay and
  • Western Blot.

2) For related STDs:

  • For herpes - IgG and IgM ELISA for HSV (herpes simplex virus) type 1 and type 2.
  • Hepatitis B - HBsAg (Australia antigen) test.
  • Hepatitis C - Anti-HCV IgG antibodies.
  • Throat swab for - Gram Staining, AFB staining, Bacterial pus-culture, KOH (potassium hydroxide preparation test for fungus).

3) General Tests - CBC, LFT.

In conclusion, get the tests done, do not spend sleepless nights till reports are available.

Revert back with the reports to a HIV AIDS specialist online --> https://www.icliniq.com/ask-a-doctor-online/HIV-AIDS-specialist

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