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HIV Symptoms and NOT testing Positive

Question: 

Hello,

I had a lot of risk (gay, anal receptive, unprotected) in San Francisco about 21 months ago before getting sober from alcohol. Two months later, I came down with night sweats/fevers, sore throat, no energy, loss of appetite and had to go to half days at work for a few weeks. My doctor sent me to an oncologist thinking I may have leukemia. The oncologist thought it was HIV, but my doctor said I was testing negative. My oncologist did a bone marrow biopsy and found it to be negative for cancer. I tested just 3 months ago (blood test through my San Francisco doctor who works with patients who have HIV), and I tested negative again.

However, in the last 3 weeks the afternoon/night fever/sweats have returned and a slight sore throat. I was on Truvada (rarely) during the risk period 21 months ago before getting sober from alcohol. But since then, I have regularly taken my Truvada. Could this skew the test result?

Could this be HIV? Is it possible that I was infected and the blood tests don't show it because of the Truvada? A friend of mine said he got violently ill and did not test positive during that time. It took a year before he tested positive and he wasn't on Truvada.

Any thoughts?

Answer: 

Thank you for contacting AIDS Vancouver. It sounds like you're dealing with some pretty unpleasant physical symptoms with unknown causes, and you're worried that your use of Truvada is making your negative test results unreliable. I hope the following information will help you understand your situation a bit better.

The first thing I want to say is that symptoms are not reliable indicators of HIV. Some people who acquire HIV never notice any symptoms until years later. On the other hand, the symptoms that are associated with acute HIV infections are similar to the symptoms of other viral infections such as the flu. The only reliable way to determine whether you have HIV is through an HIV test administered by a qualified health care professional.

It sounds like you've at least had that testing. So let's turn to what we can say about that.

When it comes to test results, we follow the BC Centre for Disease Control protocols. Under these guidelines, HIV tests are considered conclusive 3 months post-exposure. The only exceptions are for people who:

a) Are on anti-viral treatment for Hep C
b) Are on chemotherapy
c) Took PEP treatment for HIV
d) Have an immunodeficiency disease (usually diagnosed in childhood)

In those cases, however, we still can get a conclusive test result at six months post-exposure. Based on that, we would consider your test (taken at 18 months post-exposure) to be conclusive for that exposure.

If you have further concerns, this might be something you could partner with your doctor to discuss and problem-solve.

I hope this has answered your questions.

Yours in health,

Matt, Helpline Volunteer
AIDS Vancouver Online Helpline
helpline.aidsvancouver.org
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