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Developed Rash, Sore Throat And Lymph Node On Neck. HIV Test Done. Should I Be Worried?

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Posted on Wed, 13 Mar 2013
Question: Doctor,
I was in a relationship 2yrsa go, developed rash,sorethraot 3 wks after exposure. Got tested multiple times HIV EIA 1/2 2nd generation from quest and ICMA 1/2/0 from labcorp , last test 2 yrs after high risk expsoure. Also got tested for hiv-1 dna pcr, qualitative hiv 1 rna pcr, hiv 2 dna pcr. I am concerned abt hiv 2 as i tested in usa, labcorp and the lower limit of detection is 350-500 copies. i heard abt seronegative hiv 2 in india and also type 2 replicates very slowly and i am scared the hiv 2 dna pcr missed virus detection. i also developed a neck lymphnode 30 mons after last expsoure. Pls help. I also concerned as my new partner developed fever 103 3 wks after expsoure.
doctor
Answered by Dr. Praveen Rodrigues (1 hour later)
Hi there XXXXXXX.
All instances of rash & sore throat do not point to a HIV infection. Much more simple entities like the common flu or infectious mononucleosis are more plausible reasons.
If you have done a PCR test, then it is more likely than not that you are all clear as the relative risk of missing out on an infection is minimal to negligent as even a few viral copies can be detected. If in doubt, please repeat the same said test at a 6 mth interval from the first & if both are negative (as i assume it willbe in your case), you can rest easy. Furthermore, you may wish to do an elective FNAC (fine needle aspiration cytlology test) on that irksome lymph node you describe more to put your mind at ease & to rule out any other ailment eg the more common tuberculosis et al. I dont envisage your new partner developing a fever 3 weeks after exposure to be significant either as there is no such set incubation period to worry about. Agreed entities like seronegativity does exist but that is true for any viral ailment & the time that the HIV2 virus takes to replicate is the reason i requested you to undertake 2 similar tests at a 6 mth interval..even the gold standard ELISA for HIV suffices!
If in doubt, perhaps a PCR test on the partner may help calm nerves.
All in all, relax...it appears all good & the stress will unnecessarily eat you up. Do however practice safe sex as it helps keep the mind at peace & limits such threats'.
Good luck. I trust i have managed to calm your nerves, given you a road map to help you on your way & encouraged you to live life to the fullest albeit in a safe & secure manner! Cheers!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist
Bangalore, India.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Rodrigues (49 minutes later)
Doctor,

I am concerned abt hiv 2 as this is rare in usa and hiv-2 dna pcr i did has lower detection of 500 copies and I am worried this would miss if viral load is very low and i heard type 2 replicates very slowly. and i also had 2nd generation EIA hiv1/2 28 months after exposure and was negative. what is the lower limit of hiv2 dna pcr in India? The rash I had 2yrs ago was the only symptom , i had sorethroat a week before and later i developed the rash. i went tod ermatologist and they could not figure out what it was and that scared me but 8-10 antibody tests done since then are negative.
The reason I am worried because I read case reports where viral load for type 2 lies in 100-200 copies only.

Thank you
doctor
Answered by Dr. Praveen Rodrigues (7 hours later)
XXXXXXX,
Hi there Again.
I understand very clearly what your worry is.
However, 'case reports' are just that...individual case reports. They are NOT the norm.
My advice to you is have faith & trust. Do not read extensively & believe everything on the internet. DNA-PCR tests can read less than 100 viral copies & are very sensitive. Moreover, if you have done so many tests at regular intervals, the odds ratio (statistically speaking) are in your favour!!
Often, dermatologists' cannot figure out straight away what a particular rash is..this does not mean you have HIV..it simply means the subject is vast & lots of areas unchartered. So relax...there is absolutely no need to loose sleep.
Please do the FNAC of the node as i suggested & you may do the PCR test on the new partner if you wish to take him into confidence & reassure yourself that if he is negative, then all is good for the two of you. Chill & regds!!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Rodrigues (11 hours later)
Docotr,

I spoke to lab director here in uSA who mentioned to me about lower limit dna pcr detection for type 2. i thnk the tests in usa are not well designed for type 2, the type 1dna pcr lower limit here is 10 copies but not type 2 dna pcr. and this worries me a lot even though my EIA antibody test was negative as I heard soem cases where people take years to show positive antibody tests.

Thank you
doctor
Answered by Dr. Praveen Rodrigues (3 hours later)
Hi there XXXXXXX,
Dont worry yourself about 'some' cases. The director is right on the first count in that yes upto 10 viral copies may be detected. However, i disagree that the tests in the USA are inferior. However, if you feel so strongly, please make a trip to India that can double up as a holiday & will personally see to it if you like to sort you out in Bangalore regds the tests. There are always exceptions to a rule but by & large, i think if you get your current partner tested & he is in the clear, then you can rest easy as per the concept of vicarious liability! Relax & think positive...i assure you as best i can on this portal that you seem all clear but do take precautions for the future. Please do close this query as it will give you a sense of closure as if's & but's are not going to help you further. Keep the faith & look ahead. Leave the past behind you. Cheers & Godspeed!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Rodrigues (9 hours later)
Doctor,
Thank you for your help. Even my friend assures me that I am fine. Anyway I am born here and I dont think i will be traveling to india as I have no family ties there. my friend helped me post on this forum.
thank you
doctor
Answered by Dr. Praveen Rodrigues (13 minutes later)
Hi there XXXXXXX.
I figured you were second generation American. I have tons of nephews & neices & even cousins' who are in a similar boat & I have never visited the States either:) The only reason i was suggesting travelling to India was to clear your mind while at the same time getting a holiday to effect the same. Howvever, seeing as you are now convinced you are good to go, then my job is done! Should you wish to re-open this query at a later date or chat on this issue or any other dermatology or venereology issue, please feel to call on me anytime.
In the interim, please do close this query if we are done here & do take time off to give us a healthy rating; else, any comment on this thread pops up as a 'query' at this end...My best regds to your friend too & Godspeed!
Dr Praveen Rodrigues MD
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Rodrigues (11 hours later)
Doctor,

I am going to close the discusson. I only posted this with help of my friend to relieve my anxiety. I can now go back to my college nad try to find a job as I am getting financial aid from them. Anyways I made good friends her who are born and educated in India nad they are the one who helped me find this site for my worries.
Thank you
doctor
Answered by Dr. Praveen Rodrigues (4 hours later)
Good Luck XXXXXXX. Glad to be of help. Cheers!
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Praveen Rodrigues

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Developed Rash, Sore Throat And Lymph Node On Neck. HIV Test Done. Should I Be Worried?

Hi there XXXXXXX.
All instances of rash & sore throat do not point to a HIV infection. Much more simple entities like the common flu or infectious mononucleosis are more plausible reasons.
If you have done a PCR test, then it is more likely than not that you are all clear as the relative risk of missing out on an infection is minimal to negligent as even a few viral copies can be detected. If in doubt, please repeat the same said test at a 6 mth interval from the first & if both are negative (as i assume it willbe in your case), you can rest easy. Furthermore, you may wish to do an elective FNAC (fine needle aspiration cytlology test) on that irksome lymph node you describe more to put your mind at ease & to rule out any other ailment eg the more common tuberculosis et al. I dont envisage your new partner developing a fever 3 weeks after exposure to be significant either as there is no such set incubation period to worry about. Agreed entities like seronegativity does exist but that is true for any viral ailment & the time that the HIV2 virus takes to replicate is the reason i requested you to undertake 2 similar tests at a 6 mth interval..even the gold standard ELISA for HIV suffices!
If in doubt, perhaps a PCR test on the partner may help calm nerves.
All in all, relax...it appears all good & the stress will unnecessarily eat you up. Do however practice safe sex as it helps keep the mind at peace & limits such threats'.
Good luck. I trust i have managed to calm your nerves, given you a road map to help you on your way & encouraged you to live life to the fullest albeit in a safe & secure manner! Cheers!
Dr Praveen Rodrigues MD
Dermatologist, Cosmetologist, Venereologist
Bangalore, India.