HIV Symptoms

[Cloud7]

Hi DRs,

I have a rather general question regarding the HIV symptoms. As I read, it normally takes 2-4 weeks until the body produces antibodies which often results in flu-like symptoms (ARS). These symptoms may last for up to 2 weeks, right?

Is it also right that it then takes many years without any symptoms until the Virus wins the fight over the antibodies and is able to cause serious illness?

I am asking because I didn't have any flu-like symptoms shortly after exposure. Well, I felt some fatigue. But this might have been due to stress and the extreme cold outside.

What I experienced almost 3 months after exposure were quite strong joint pains and also a more or less sudden hearing loss. I have read that both can be related to HIV. So I worry! What I am not sure about: When would these symptoms normally appear? Very early, during this ARS? Or very late, shortly before the transition to AIDS? Or - and that's actually my question - can they always appear? I supposed that once the antibodies are produced, the HIV gets kinda passive, at least in attacking the body and causing symptoms.

BTW: My (high) risk was unprotected anal sex with a woman of unknown HIV status. I did a test after 6.5 weeks which came back negative.

Thank you for taking your time and answering my question.

[Edward W Hook, MD]

You have a good understanding of the timing of the ARS and the subsequent time course of HIV infection.  However, you have seemed to missed our repeated statements that the symptoms of the ARS are TOTALLY non-specific and when people experience "ARS symptoms" they are much more likely to have something else, usually some other, more typical virus infection.  When this has been studied in the US, less than 1% of persons seeking medical care for "ARS symptoms" are found to have HIV, the remainder having symptoms due to other processes.  In addition, it is also important to realize that many person who acquire HIV do not experience the ARS.  For a person to try to judge their HIV risk based on "ARS symptoms" is a waste of time.  Thus, based on these facts, I would counsel you to not be concerned about your joint pains or hearing loss as potentially related to HIV.  Rather, I would urge you to work on this with a health care provider to address what is really causing your problems.  (also, while joint pains can be part of the ARS, hearing loss is neither a common manifestation of either early or late HIV.)

Furthermore, while rectal sex is "high risk", this is only the case when your partner has HIV.   You have not indicated anything to suggest that you know your partner had HIV or was likely to be infected.  In fact, HIV is rare in the general population.  Finally, the fact that you had a negative HIV antibody test more than 6 weeks following your exposure at a time when over 95% of persons who are going to develop HIV antibodies would have, add further strength to my assessment that it is very unlikely that you have HIV and that you should work with a doctor to sort out your symptoms.

Hope this helps.  EWH

[Edward W Hook, MD]

You are rpeatedly asking the same question using somewhat different words.  You can read my responses above.  You have little if anythng to worry about from the exposure you describe.  This post is over.  EWH

[Cloud7]

Thank you very much, DR Hook! It indeed helps, but may I add one last question just to make sure if I understood correctly:

So can I say that symptoms of early infection are automatically related to ARS which would make them appear most likely after 2-4 weeks? Or is it possible that there are also "independent" symptoms caused not by production of antibodies, but directly by the virus (and not related to ARS) as late as 3 months after exposure?

Sorry for asking again, but I'd like to know if I can rule out a connection between the appearance of symptoms and the virus after (e.g. 3 months) and before (e.g. 10 years) a certain time.

Thanks again!!