Swollen Lymph Nodes

[thelastime1]

Dear Doctor, could you weigh in on my question I posted within a hour ago titled " Swollen Lymph Nodes ?. Again." Thanks.

[thelastime1]

Thanks for kindly answering my questions. Just curious what single symptom is more common in respect ARS? Thanks again for your help, much appreciated.

[thelastime1]

I have already posted my risk " ask a doctor" over a week ago. So  my risk assessment was already given. You're right that I'm not at all qualified to determine if my lymph Nodes are swollen. Its a guess because I feel pressure and mild discomfort in the areas that the lymph Nodes are located for far longer than I should with out having any symptoms. My risk was with a working transsexual who inserted me with a condom, I hope, and after 30 seconds to a minute I pulled away and the condom was not on the TS but stuck to my rectum, what is not certain is if the condom did its job or not. The TS didn't really seem concerned about safe sex, I kept insisting that condom be on at all times if during oral. I'm not sure if the condom was inside my rectum or just stuck to the outside. Another reason of risk is that the TS would not answer direction question of her/his Hiv status that I asked multiple times. I didn't want to post my risk again cause a previous doctor had already assessed my risk exposure and if I should take PEP. My question you kindly addressing my questions.

[H. Hunter Handsfield, M.D.]

OK, that makes it easier.  Thanks.

I'm not familiar with Oster.  Most HIV/STD specialists would not agree with the statements you attribute to him.  Asymptomatic HIV seroconversions are not rare (I recently cared for such a patient), but the consensus is that 80-90% of people with new HIV infections have symptoms.  They may are mild and easily missed, but probably at least half of new infections cause sympoms that would be hard to miss.  Most pertinent to your concerns, lymph node inflammation and enlargement (lymphadenopathy) are rarely if ever the only symptom.  When lymphadenopathy occurrs, it usually is accompanied by fever (over 101 degrees), sore throat (often severe), and a non-itchy skin rash, mostly on the trunk; 70% of symptomatic persons have all 3, with or without lymphadenopathy.

Self-diagnosis of lymphadenopathy is very unreliable.  Without professional evaluation and confirmation, I am inclined to believe that your lymph nodes are enlarged.  But even if they are, the timing is inconsistent with ARS; onset is generally 7-14 days and 3 days is much too soon.

You don't describe the exposure you are concerned about, so I cannot judge your risk from that standpoint.  But based on your symptoms, you can be confident you do not have ARS from that event.  If the swellings, whatever they are, continue, or if you have other symptoms that concern you, see a doctor or clinic for professional evaluation.

Regards--  HHH, MD

[thelastime1]

I was reading an article by a Harold Oster on a website called ivillage.com about initial HIV infection. " Most people with initial HIV infection appear to have no symptoms at all. On examination, however, some of these people have a condion called persistent generalized lymphadenopathy.  The lymph nodes swelling is cause by the rapid multiplication of the virus itself at these sites." This concerned me since for over a week my lymph nodes behind my neck and possibly my armpits are swollen. This concern of my swollen lymph nodes started 3 days after possible exposure, which I've already posted. The article seems to contradict  what I've been told.  you have multiple symptoms " syndrome" or no symptoms. Not just one symptom during sero-conversion. Hence ARS. I do not have any other symptoms beside swollen lymph nodes. Could you please give some insight? Thanks.

[H. Hunter Handsfield, M.D.]

Please re-post the question here, in a comment window -- then I will respond.  If you like, you can just copy and paste.  Neither the moderators nor other readers are expected to have to refer to other threads to understand the discussion.  

HHH, MD