HIV Testing and Symptoms: Your Questions Answered

HIV testing issues?

Hello Dr.
Hong, I had an encounter with a woman on November 9th last year.
About two to three days later, I developed a low-grade fever, sore throat, and a rash.
After taking cold medication, I improved.
As of today, I have not experienced any other acute HIV symptoms, but the skin rash has persisted.
The number of rashes is usually small; some are itchy papules, while others are small patches less than the size of a five-dollar coin, most of which disappear in less than a day, although the papules tend to last longer.
I couldn't help but go to a testing center for a PCR test on the ninth day, which came back negative.
My most recent rapid test at seven weeks was also negative.
Can I temporarily feel reassured? The skin symptoms were evaluated by a doctor, who said they are chronic allergies.
I am more concerned because I have not had allergy symptoms before, and this is a recent development.
If I can feel reassured for now, would it be sufficient to do another rapid test after three months to confirm that everything is fine? Thank you for your response.

Nìmíng zhě, 30~39 year old female. Ask Date: 2020/01/04

Dr. Hong Yuanbin reply Internal Medicine

Hello, in response to your questions, I will address them in several parts:
1.
Regarding the possibility of HIV infection, it is recommended to undergo a second screening test at three months to confirm that there is no infection.

2.
Concerning the skin rash, I am unsure about its distribution—whether it is near the genital area or on the body trunk.
If it is near the genital area, I suggest consulting a urologist to determine if it is related to a sexually transmitted infection.
If it is on the trunk and the dermatologist believes it is an allergy, you may start using antihistamines and monitor the condition.
Thank you for your inquiry.

Reply Date: 2020/01/04

More Info

When it comes to understanding HIV testing and symptoms, it's important to recognize that the process can be complex and often involves multiple factors. Based on your situation, it seems you have had a potential exposure to HIV and have experienced some symptoms that have raised concerns. Let's break down your questions and provide clarity on the testing process, the significance of symptoms, and what steps you should take moving forward.

Understanding HIV Testing
1. Types of Tests: The most common tests for HIV include antibody tests, antigen/antibody tests (often referred to as combo tests), and nucleic acid tests (NATs). The PCR test you underwent is a type of NAT that detects the virus itself rather than the antibodies. This test is very sensitive and can detect HIV earlier than antibody tests.

2. Window Period: After potential exposure to HIV, there is a window period during which the virus may not be detectable. For antibody tests, this period is typically 3 to 12 weeks, while for NATs, it can be as short as 10 days. Since you tested negative at 9 days and again at 7 weeks, this is a positive sign, but it’s crucial to follow up with another test at the 3-month mark to ensure conclusive results.

3. False Negatives: While rare, false negatives can occur, especially if testing is done during the window period. Given that you have had two negative tests, the likelihood of being HIV positive is low, but not impossible until the 3-month test confirms it.

Symptoms and Their Significance
1. Acute HIV Symptoms: Symptoms such as fever, sore throat, and rash can occur during the acute phase of HIV infection, typically within 2-4 weeks after exposure. However, these symptoms are not exclusive to HIV and can be caused by various other infections or conditions.

2. Skin Rash: The skin symptoms you describe, including small itchy bumps and transient rashes, could be related to a number of factors, including allergies, other viral infections, or even stress. Chronic allergies can develop at any time, and it’s not uncommon for individuals to experience new allergic reactions as they age or due to environmental changes.

3. Consulting a Healthcare Provider: Since you have seen a doctor who diagnosed your skin condition as chronic allergies, it’s essential to follow their advice and possibly explore allergy testing if the symptoms persist.

Moving Forward
1. Follow-Up Testing: It is advisable to get tested again at the 3-month mark after your potential exposure. This will provide a more definitive answer regarding your HIV status. If you continue to have concerns or symptoms, do not hesitate to consult with your healthcare provider for further evaluation.

2. Mental Health Considerations: The anxiety surrounding potential HIV exposure can be overwhelming. It’s important to address your mental health and seek support if needed. Engaging in open conversations with healthcare professionals about your fears and concerns can help alleviate some of the stress.

3. Preventive Measures: If you are engaging in sexual activities, consider using protection consistently to reduce the risk of HIV and other sexually transmitted infections (STIs). Regular testing is also crucial for sexually active individuals, especially if engaging in high-risk behaviors.

In conclusion, while your recent negative tests are encouraging, it is essential to follow up with another test at the appropriate time to confirm your HIV status. Addressing your skin symptoms with a healthcare provider is also important, as they can help determine the cause and appropriate treatment. Remember, staying informed and proactive about your health is key to managing any concerns you may have.

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