Can HIV cause enlargement of inguinal lymph nodes?
Patient's Query
Hi doctor,
I had a high-risk exposure with a CSW (Commercial sex worker) 167 days back. Did the following PCRs (Polymerase chain reaction), ID NAT (Individual donor nucleic acid testing) for HIV (Human deficiency virus) 1 and 2 at 19 days and repeated the same at 67 days. Then nearly ten fourth-generation tests till 158 days. My question is, can HIV hide in the local inguinal nodes (eclipse period) for 67 days and not appear in the ID NAT test? My inguinal nodes are enlarged 10 days after exposure, and a small chain of pea-like nodal structures can be felt on the inner sides of my thigh.
Kindly guide.
Hi,
Welcome to icliniq.com.
I understand your concern. After a negative nucleic acid test (NAT) at 67 days and ten negative fourth-generation tests at 158 days, I can rule out HIV (human immunodeficiency virus). Also, I would like to state that female-to-male transmission of HIV through vaginal intercourse is not very efficient (compared to anal sex or male-to-female transmission). Are the nodes painful? Do you have a rash, weight loss, and night sweats? I would suggest an FNAC (fine needle aspiration cytology) test for this condition and share the report. This test procedure will include passing a small needle through the lymph nodes to aspirate diagnostic material. I hope this helped.
I hope this helps.
Thank you.
Patient's Query
Hi doctor,
Thank you for the reply.
My lymph nodes are not painful by themselves, but only on palpation. So my questions are as follows: Are pea-sized nodes in the axillary, epitrochlear & inner thighs normal or pathologic? They say that the virus multiplies in the local lymph nodes for months (rarely) without disseminating into circulation. If that is so, it has to enter the bloodstream to travel from that local lymph node to distant nodes like the axillary or the thighs.
Hi,
Welcome back to icliniq.com.
I understand your concern. The answers to your questions are as follows. If nodes are multiple and enlargement persists, then FNAC (Fine Needle Aspiration Cytology) should be done to rule in or rule out any pathology. An HIV antibody response can be detected as early as two weeks in a few people and more than 99.9% of people by 12 weeks. The HIV window period can last from two weeks to six months sometimes. Yes, HIV will travel through the bloodstream and lymphatics, but the concept is that multiplication to a good number is necessary to detect HIV. In my opinion, you can rule out HIV and go for an FNAC for further evaluation.
I hope this helps.
Please feel free to reach out in case of further queries.
Thank you.
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