HIV, No Symptoms, Just Swollen Lymph Nodes (Neck, Arm, Elbow)

CarolL72 Asked :

About 2 years ago I was in a serious relationship for about 6 months and I recently discovered that he died of AIDS. At the time he had not mentioned anything about being HIV positive and after contacting his sister, I discovered that he knew his HIV status for many years even before we started dating. I am worried about whether I am positive although we used protection all the time since I was not prepared to use the pill.

I have had none of the early HIV symptoms and I had a finger prick test at work about 18 months ago which was negative. I am terrified about having a test now because I have been feeling like something is wrong for a year or so. I had the flu twice in the past 8 to 9 months, which is rare for me, because I never get the flu. However, I did relocate to a colder part of the country about a year back due to a change in career. I have felt little lumps on my neck, arm and elbows especially, which seems to be swollen lymph nodes and I know that this is a common sign of HIV. Other than that I have no other health problems.

Could I be HIV positive and not showing any signs of symptoms of it? Shouldn’t I be showing some signs and symptoms at this stage?

This question was posted under the First HIV Signs – Early Infection Symptoms, Risks, Other Cause article.

Dr. Chris Answered :

HIV infection is definitely possible but it would be difficult to diagnose without the presence of AIDS-defining illnesses and the relevant tests. While up to 80% of patients will experience the first signs of infection, it is possible that you did have it and just cannot recall or attributed it to the flu or some other illness at the time. It is also possible that you did not show any of these signs (20% of cases).

In most people who are HIV-positive, there is an asymptomatic period which can last for up to 10 years, sometimes longer or shorter. Generalized lymphadenopathy (swollen lymph nodes throughout the body) which is persistent (meaning it lasts for 3 months or more) is one of the common signs in the asymptomatic infection stage. Even if it is not occurring throughout the body, the fact that it is present in at least 2 different sites makes this very relevant. If the enlarged nodes are greater than 1 centimeter (cm) in diameter is another important indicator.

In the 90s in sub-Saharan Africa, where medical resources and testing facilities were limited, the presence of palpable (‘can be felt’) epitrochlear lymph nodes (elbow) along with swollen nodes elsewhere was considered a good indicator of HIV infection.

Many people living with HIV do not experience any significant signs or symptoms for this asymptomatic period, not even the seasonal flu. A lot depends on your lifestyle (diet, exercise and mental/emotional state) during this time. A colder environment, especially if you are not used to it, can result in repeated bouts of a cold or flu even without HIV infection. A career change in addition to relocating is stressful which could have also caused your immune system to dip during that time (not related to HIV infection). Before making any assumptions about your HIV status, rather speak to your doctor or visit a clinic where you are comfortable with the staff and discuss your testing options. An HIV test is definitely necessary in light of what you have discovered about your previous partner.

With regards to your first HIV test, it is possible that you were not infected at the time or you were in the “window period” during this period. It is difficult to assess this based on your account of the events that transpired at the time but from what you say, you were either still seeing your partner or had just ended the relationship. The “window period” can last up to 12 weeks and in very rare cases, up to 6 months. Another possibility is that you are NOT HIV-positive. Hopefully this is the case.

Attempting to diagnose (especially self-diagnosis) HIV infection and contemplating the possibility given the information you now have discovered about your partner can be very stressful. It this type of emotional stress that can impact your current health status if you are HIV-positive or even if you are not, it can be trying. It is better to find out your status at the earliest possible stage to put your mind at rest. If you are HIV-positive, an early diagnosis and evaluation of your CD4 cell count and viral load will allow your doctor to monitor you closely and start with ART (antiretroviral therapy) as soon as it becomes necessary. This could significantly prolong your lifespan.

A point to bear in mind : testing does not change your status – you are either positive or you are not.

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