Had A Potential Exposure. Experiencing White Coated Tongue, Mild Night Sweats And Swollen Lymph Nodes. Depressed And Worried. Advise?

Posted on Mon, 21 Oct 2013

Question: I had a potential exposure on August 4 of 2013 and started to experience symptoms later that month:white coated tongue,fever,mild night sweats,hard swollen lymph node behind both ears,no swollen lymph nodes anywhere else,weight loss,mild fatigue,no coughs at all,along with other HIV/AIDS symptoms,I went and received a standard ELISA Antibody test from health clinic 20 days after the possible exposure,Negative,Antibody 1&2 Test from LabCorp at 39 Days after other symptoms developed,Negative,and another HIV antibody test with preliminary Conformation,i believe Western Blot,from panel 0000 of LabCorp at 51 days,Negative along with testing of all other STD's,came back negative,but symptoms dont go away and CBC testing was all in normal reference range,as well as urinalyis test and microbology test since the possible exposure I've been extremely stressed,sometimes depressed,and showing signs of Anxiety,I want to know are my results accurate,and I'm causing myself to have these symptoms or what?

Answered by Dr. Roopa Hiremath (1 hour later)

Brief Answer:
HIV testing

Detailed Answer:
Hi XXXXXXX

Thanks for choosing XXXXXXX for your query.

I understand your worry regarding the potential exposure.
I want to give you few details about HIV and HIV testing.

HIV after entry into the body, multiplies in the lymph nodes and spills back into the blood.
This takes 4-11 days and during this time, PCR is the only test which can detect HIV.
Coming to antibodies against HIV, these are produced 2-8 weeks after infection and are detectable only after 3 to 12 weeks.

HIV testing for individual after potential exposure is done following a strategy III.
This strategy is called the three kit strategy where the sample is subjected to the first test usually an ELISA for HIV antibodies.

If this test comes positive, the sample is subjected to another test.
If this test also comes positive, a repeat confirmatory test is done and then only it is given as positive HIV status.

ELISA tests commonly used are third generation and fourth generation kits which detect antigens and antibodies against HIV 1 and 2.

Western blot is one of the confirmatory tests done to detect HIV status.
It is one of the highly specific tests available for HIV antibody detection.

Now, coming to your test results,
20 days after exposure (three weeks) - you tested negative.
39 days after exposure (five weeks) - you tested negative.
51 days after exposure (six weeks) - you tested negative.
HIV status is given as negative when two consecutive tests done come negative.

I hope I have answered your query satisfactorily.

I suggest you relax and get in touch with your GP for symptoms you are having which are suggestive of flu like illness.

Please do not hesitate to get back if any clarifications needed.

Thanks,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Roopa Hiremath (1 hour later)

So if someone has already developed hiv/253657?iL=true" >AIDS and they take HIV antibody test with prelimilary conformation and CBC,microbiology test,urinalysis test,chemistry test,hematology,serology test would these test detect AIDS in any of the blood or urinalysis sample?

Answered by Dr. Roopa Hiremath (6 hours later)

Brief Answer:
HIV testing and AIDS

Detailed Answer:
Hi XXXXXXX
Welcome back to Health care magic.

Let me clear your doubts about AIDS.
AIDS is acquired immunodeficiency syndrome caused by infection with the virus called human immunodeficiency virus (HIV)
Most common mode of infection is sexual intercourse and the virus gains entry into the body through the mucosa lining the genitalia.

So if condoms are used during sexual encounters the risk of infection is reduced to almost nil.

As I had explained in my previous answer, after entry the virus multiplies in the lymph nodes and then spills back in the blood.

So blood is the sample to test for HIV and its antibodies.
It cannot be detected in urine easily.

The tests you have undergone are routine investigations done to rule out other causes for your symptoms.
HIV testing has to be done by blood test only.
Now coming to AIDS, WHO(World Health Organization) has divided HIV disease into four stages:
Stage 1 - usually no symptoms
Stage 2 - rashes, repeated upper oral ulcers and some weight loss.
Stage 3 - Diarrhea for more than 1 month, fever, more weight loss, repeated mouth ulcers and patient becomes bedridden
Stage 4 - AIDS - last stage, and many infections occur which are called as opportunistic infections.

What I am trying to tell you here is that a person does not develop AIDS as soon as exposure.
It may take months to years to reach the final stage of HIV disease which is called full blown AIDS.

I hope I have cleared all your doubts successfully.
Thanks.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Roopa Hiremath (2 hours later)

So is there a chance that someone doesnt produce antibodies to fight the HIV virusbefore AIDS occurs or any opportunistic infection?

Answered by Dr. Roopa Hiremath (22 minutes later)

Brief Answer:
Window period HIV testing

Detailed Answer:
Hi XXXXXXX
Welcome back.
The period following the entry of HIV into the body and the appearance of detectable levels of antibodies is called “window period”.
During this period the person is infected, and is infectious but tests negative with antibody detection tests.
This window period varies in different individuals and the reason for this variation is still not understood.
The ideal time for the antibodies to become detectable is 3 - 12 weeks after exposure in most cases.
There are other tests which can be done to detect HIV during this window period.
These tests include p24 antigen detection and PCR for viral RNA.
I hope I have answered your query satisfactorily.
Thanks.

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Above answer was peer-reviewed by : Dr. Vaishalee Punj