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HomeAnswersCommunity MedicinehivCan HIV cause itchy scalp and swelling near the collarbone and left wrist?

I have itchy scalp and swelling near the collarbone and left wrist. Is this related to HIV?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At August 6, 2020
Reviewed AtDecember 20, 2023

Patient's Query

I had intercourse with a female sex worker. I had used the protection which broke either during or perhaps before penetration. But after I experienced continuous change in sensation, I checked and the condom was broken, at which point I withdrew from the intercourse before ejaculation. I asked the girl about her history and she told me she started having paid sex very recently and that she hadn’t been doing this for too long and told me she was clean, though I can’t trust that totally. Since then, I had severe anxiety and experienced body pain, throat trouble and tiredness etc. I took a CBC test on the 10th day (CBC Report attached). Then, after an exact gap of 10 days post-intercourse, I took the HIV RNA PCR Qualitative test, and the report said "not detected" (PCR report attached- the lower limit of detection of this test was 100 copies / mL). On the same day, I also went to an ENT for throat issue and he prescribed me some medicines (ENT Prescription attached). However, there still seems to be some throat trouble.

However, even after the test, I have been very anxious since my exposure. A few days after the exposure, I started experiencing head itching, which eventually became a bit more and I went to see a dermatologist who I told about my exposure also. He wrote me a prescription for a lotion (Zydiwon) and a tablet (Teczine) for head itching.

Ever since my exposure, I have felt pain in my left wrist. Apart from that, I have a lump on my right collarbone, where it meets the throat. I have had this for about one or months now after exposure. Ever since a few days after exposure, I have occasionally felt mild pain around my chin which comes and goes. Apart from that, sometimes I have some pain in and around my ear and at the back of my head, where I suspect there is some swelling on the left of the back of my head, but I haven’t been to a doctor for this. Recently, I went to a general physician about his and he asked me to get my Uric Acid checked, and I did. My Serum Uric Acid came to be 6.65 against the normal reference value of 3.6 – 7.7 mg/dL (Male). I also notice sometimes a swelling towards my left inguinal region. However, I recall this being there even last year.

Since my exposure, and especially these days, I have been very anxious and stresses regarding the possibility of contracting HIV. I have not taken any test after RNA PCR. I am especially worried since I read it online that scalp itching (seborrheic dermatitis) can be because of HIV and also that persistent swollen lymph nodes or glands are signs of HIV. Kindly go through my reports and advise me. I have been really worried.

Hi

Thank you for the query.

The chances of transmission of HIV by unprotected intercourse with a HIV positive person is very low. If protected almost nil. The HIV RNA PCR is negative after 10 days exposure is almost more than 95 % accurate. The chances of HIV tests coming positive later is almost nil. But it is better to go for HIV antibodies test after 3 months exposure to have final conclusive results. The symptoms are non specific and do not suggest HIV.

Patient's Query

Hello! Have you been able to see all the reports and prescriptions that I have annexed along with my query? I have these following queries-

1. The lower limit of detection of the RNA PCR as provided in it says 100 copies/mL. Is that sensitive enough for perfect detection or is this test any less sophisticated? Also, I took the test on the 11th day of exposure. Did I cross the window period or did I take the test earlier than I should have, thus hindering its accuracy?

2. I am worried about the fact that I read online that seborrheic dermatitis and persistent swollen lymph nodes or glands are signs of HIV. I have had head-itching and also swelling near collarbone, left wrist and behind head. Is this related to HIV?

3. I shall be completing 3 months since exposure. If I have to take an antibody test, is this ELISA H3T profile good enough for HIV detection? If yes, when can I take it?

4. What are the chances of negative or undetected as shown in PCR RNA test now turning positive in the antibody test? Kindly answer these questions. It should help.

Hi Thank you for follow up query. I have gone through the reports. Do not worry about HIV RNA PCR test and the copies. It is very good sensitive test after 4 days exposure itself. But best after 10-14 days exposure. Anyway go for HIV antibodies test, Elisa is good .It is considered conclusive after 3 months exposure. The symptoms are not suggestive of HIV. It may be just dandruff and not full blown seborrheic dermatitis as per your history. So do not relate each and everything to HIV. The chances of tests coming positive later after HIV RNA PCR negative tests is almost nil. Just relax, forget episode and go for HIV antibodies test after 3 months exposure.

Patient's Query

Hello,

In consequence of our previous discussion, having completed 90 days since exposure, I took the H3T test primarily for HIV 1 & 2 antibody test. The reports came in. Though the interpretation is negative, my worry and concern is because of the value it shows of 0.21. Last year, I had a risky exposure, following which I took an ELISA test after 7 days of exposure and then finally one after 4 months. Both these reports from last year are being annexed as 1 and 2.

I am providing the values of the following below. The first column represents values from last year, the second column from 4 months after last year's encounter, and the third and last column represents this years's results for the exposure 3 months ago. Anti HSV - 0.07, 0.05, 0.04 HbsAg - 0.12, 0.15, 0.18 HIV 1 & 2 - 0.03, 0.06, 0.21 TSH - 1.10 2.13, 1.91

This year's test was not ELISA but ECLIA. My query is this- The values in all other components has stayed around the same with very minor variation in this year's report from the last reports. However, the only exception is the values for HIV 1 and 2, which has gone up from 0.03 and 0.06 last year to 0.21 this time. What accounts for this increase? Am I at risk? I have not tested for any STDS. I am very concerned. I seem to have swelling in wrist and a lump on collarbone and experience joint pain. Kindly go through all three reports and help. Apart from this, I had taken RNA PCR QUAL 10- days after exposure this year which said not detected.

Hi Thank you for the follow up query . The HIV antibodies test is negative after 3 months exposure is conclusive. You are free from HIV provided there is no further risk exposure. Do not worry of the minor variations in the titer values. There can be minor variations in the test or readings etc. What is important it is negative .The symptoms and swelling do not suggest HIV. Do not relate everything to HIV. Forget about HIV and lead a normal life.

Patient's Query

Ok.

So the change from 0.06 last year to 0.21 in HIV 1 and 2 value this year is only minor variation as per your opinion? Were you able to see reports? Also, having taken the HIV test, do I need to test for STDS as well to be on the safe side? Also, any difference in accuracy of ELISA and ECLIA (which is the current test I took)?

Hi Yes. These are only minor variations. I have seen your attached reports. You can go for STDs panel test as a routine. Both ECLIA and ELISA are similar tests and give similar results.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Basti Bharatesh Devendra
Dr. Basti Bharatesh Devendra

Dermatology

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