Good day Dr McGovern , I'm a 39 year old , slightly overweight male in the UK, smoker and drinker. Following a high risk exposure of unprotected sex with a woman on her period (what was I thinking!) who turns out is HIV+ I had an ARS-like symptoms 3 weeks after. I was tested for the bacterial STIs at 28 days. I tested negative for HIV1/2 (DUO) HBV, HCV, Syph 14 weeks after that. I think it was core antibody they tested for in the Heps. I also tested HIV-1 M / HIV-2 -ve by INSTI 22 weeks after. No Herpes, CMV, HTLV, LGV, EBV testing done.

At the 22 week physical exam the Doctor palpated the nodes at the back of my head and was a little rough. The next morning the nodes there and elsewhere were very sore and I was quite ill for about 4 weeks after - diarrhoea (not severe though), green stools, worst fatigue I've had ever, nausea, vomiting, chest pains, all over joint and muscle aches, yellow eyes, itching all over, cloudy urine.

Prompoted by sore groin nodes at 27 weeks the GP's nurse did a Multistix test and found nonhemolysed trace of blood in my urine. This was after I did a home test 2 days before and the Urobilinogen was off scale and Biluribin moderate. I went for the scheduled 6m Hep test at 28 weeks and I tested for Hep C (core antibodies I think). Nodes around groin were slightly painful but she dismissed them and didn't check. The clinic will do no further testing as they said have satisfied the BASHH guidelines, though I read them and it says sometimes it takes up to 9 months for Antibodies to be detectable. They also don't offer PCR testing.

Only remaining symptoms now at 32 weeks are cloudy urine, pain at back of knees (popliteals), armpits and lymph nodes around ears, front of eyes burning and reall painful groin nodes. I'm going to my GP for evaluation of symptoms end of the month (unless they are due to STDs inc HIV or Heps) and type 2 Diabetes (since I had raging thirsts). Meanwhie I'm laying off the sugars, fatty foods, alcohol and trying to take more exercise.

1 Could the Dr palpating my nodes have caused something? 2 Do the symptoms above at 22-26 weeks sound like Acute Hepatitis, 3 When would the right time to test after Acute Hepatitis symptoms be? 4 Do I need to test to 6m for HepB as well? 5 Should I go to a different GUM clinic out of town and test further for HIV, Hep B or Hep C?

Greatly appreciated, F

It seems that you have had a great deal of testing and I suspect that your symptoms are not related to hepatitis or HIV viruses. The symptoms around 22 weeks could be related to hepatitis - but if there was no new risk - your HCV antibody should have been positive by now. The issue of testing out to 9 months is important if you have already acquired one of these viruses - you have not.

I would consider Hepatitis B immunization so you do not have to worry about this in the future.