Q. I had negative HIV tests with a swollen lymphnode in my underarm. Am I in window period?

Answered by
Dr. Bharatesh Devendra Basti
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 16, 2020 and last reviewed on: May 28, 2020

Hello doctor,

I am 29-year-old, married male. I have a baby who feeds on breast milk. I had a sexual encounter before 8 months with a professional with a condom. I am 95% sure that my protection was intact. Then I started reading about the HIV symptoms and technicalities of testing online. Five days later, I went to a Dermatology and Venereology specialist and described about the incident. He was confident enough that he advised me not to go for any testing. Although my fear of infection remained.

Around two months post-exposure, I felt tenderness here and there like on the back of my head, arms, one lymph node in my underarm was swollen and I developed cold and cough. I started sweating during that time as well. I looked a bit thinner. I got panicked and went to the doctor again. He checked me and was still confident that I am not infected. But for my mental satisfaction, he prescribed me thorough testing which includes HIV1/2, VDRL, HBsAg, HCV along with urine R/E, M/E, C/S analysis.

On 74 th day post-exposure I took all those tests and they all came back negative. After lapse of a few days again I felt some skin irritation on theback and burning sensation on my forearms. Although no skin changes can be seen. Again I got panicked thinking that I may be in the window period for HIV. But the doctor remained confident and he adivised me not to go for any repeat testing. But my sense of fear, anxiety, panic, guilt, and impurity continues.

On 110th day post-exposure again I repeated the tests but I excluded the urine analysis this time. All the tests came negative again. The HIV tests were fourth-generation combo test both the time. I am on the eighth month post exposure. Still, I feel tenderness hear and there. Recently, I am developing small red blood vessel like dots just underneath my skin on my hand and feet which is staying for 5-7days and going away leaving faint black spots. I again showed it to the same doctor. He is confident and repeatedly asked me to stop worrying. He also gave me anti-anxiety, anti-OCD, anti-depressant drugs.

I am also taking sessions with a psychologist. But still, my mind is not free from the fear of HIV and also fear that my wife and child might get infected by me.

My questions are, do I need to repeat any test to out rule the probability of HIV? Are there any probability of error from lab test given the fact that I took the tests twice? Do I need to worry about the window period as there is conflicting information available on the internet? Do I need to worry about the phenomenon of delayed seroconversion? Do I need to opt for the tests from a different lab? Do I need to worry about HIV 1/2anymore? How to unroot the fear from deep inside my mind? Any other opinion on my history?

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome to icliniq.com.

The chances of transmission of HIV by the given description is almost nil. HIV tests are repeatedly negative and after three months of exposure it is conclusive. You are free from HIV. There is no need for you to worry about seroconversion.

You can forget about the episode and lead a normal life. There is no need for any further HIV tests in any lab. Just relax. Do some yoga, exercises, meditation, etc.


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Thank you doctor,

What is the reason for tenderness here and there? I have also done complete blood analysis where no severe deficiency found except lack of Vitamin B12, high cholesterol, and liver function problem. My eosinophil level was 7 and lymphocyte was 19. These tests were also done on 74th-day post exposure. Why one painful swollen lymph node occur almost two months after exposue in the underarm? One pea-sized lump I felt twice during these eight months post exposure on my upper abdomen, where the lump was not painful itself but tenderness felt around the area of the lump. It lasted for 5-7days. Why is that? Is there any chance of error (technical, medical or human) in the tests done by the lab (twice on 74th and 110th day post exposure)? The fear of HIV is killing me. Please help.

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
#

Hi,

Welcome back to icliniq.com.

Do not relate each and every symptom or illness to HIV. There are so many diseases or simple illnesses. Once HIV tests are negative after recommended days, you are free from HIV. Do not worry about it. The symptoms are not specific and do not suggest HIV.

Axillary lymph node can be due to any skin infection or wound anywhere in arm or local chest area. So maintain hygiene and treat any local infection if any.

Abdomen swelling may be due to any lipoma or other condition. If it persists or enlarges or get any symptoms consult your doctor for examination and treatment.

Take appropriate dietary supplements and treatments for deficiencies and excess of vitamins, cholesterol, etc. Forget about HIV totally.


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Hello Doctor,
Thanks for your clarification. It helped me a lot. I am trying to accept the fact but everytime I started to overcome the anxiety something is triggering the fear again and again.
This time new red rash over my thighs and forehands and chest. First one rash appeared on my chest. Then under my right thigh and a few tiny one on the upperside of both thighs. This time it is bit swellen like insect bite. Today again I found smaller one on my forehands. Appearence wise it looks a bit different from the one I have on my chest . The rashes on the thighs and forehand have a faint itchy sensation. Now I have thesemany! I am attaching photos of them. I am frightened again. Please guide.

Doctor, although I have used condom (95%sure that it was intact)and my reports are non reactive twice, one thing I wanted to know is, what are the chances of female to male transmission from a single exposure?
Thanks a lot.

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
# Hi
Thank you for the query.
The rashes can be due to irritation or allergies or bites etc.
These are not specific and do not suggest HIV.
You can use a milder soap if required.
you can take antihistamines like cetirizine.

The chances of transmission of HIV by a single unprotected sex with a HIV positive woman is very very low .
if she is negative there is no chance.
You need not worry about HIV.

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Doctor Can I be 200 %sure about my HIV status? Can I continue my normal conjugal relation with my wife without any fear or anxiety of transmission? I have a breast feeding baby as well. Your re assurance is a bliss for me.
Thanks

Dr. Bharatesh Devendra Basti

Community Medicine Dermatology HIV/AIDS Specialist Preventive Medicine Venereology
# Hi

If the HIV antibodies test is negative after 3 months exposure you are free from HIV. As per the description it is negative after 3 months exposure. You are free from HIV. You can have normal relationships with your wife.

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