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HIV Prevention (Expert Forum)
Very Unusual Case
Answered by
University of Washington
Seattle - WA
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No questions will be accepted on the treatment of HIV/AIDS or its complications, viral load, and similar topics. If you have questions about a specific STD other than HIV/AIDS, please visit the STD Forum. Questions that do not pertain to the above topics will be removed from the forum.
If you have not done so, please review other threads in our archives for questions similar to yours and Dr. Handsfield's replies. Questions that duplicate other frequent ones, for which abundant replies exist, and that have little educational value for other forum users, will be DELETED WITHOUT RESPONSE. YOUR PAYMENT WILL NOT BE REFUNDED. The most common examples of such questions are those about low risk exposures to HIV, such as oral sex, condom- protected intercourse hand-to-genital exposure, and nonsexual contact with possibly infected blood or body fluids as well as symptoms of early HIV infection.
Very Unusual Case
by daveed, Jan 26, 2007 12:00AM
Doctor, I have never seen a question like this answered before so i hope you can help me. I have had erythematous candidiasis on the roof of my mouth for almost 8 months now. This first occurred roughly 6 weeks following unprotected sex with a female who i learned was very promiscuous yet stupidly had unprotected sex with.
The candidiasis has been confirmed by an oral specialist who has ruled out through what he called systemic blood tests, (3 samples of blood taken), any 'systemic causes'. The infection responds to anti-fungal lozenges but reappears immediately after I finish the course (of nystatin).
I have had 6 4th Generation Hiv tests with the antibody/p24 duo tests in the UK up to 25 weeks. I am still extremely worried that I am a late seroconverter because i know how rare persistant oral fungal infections are in young healthy people, and the joys of searching the internet have informed me that this condition is a common manifestation of HIV.
I realise that getting this condition so soon after infection and then taking longer than 6 months to show up on tests would be very rare - but so is an oral fungal infection with no predisposing factors (anti-biotic or steroid use, diabetes etc).
The only other symptoms I had after the incident came about 4-5 weeks after the incident when I had a kind of inner trembling (it felt like my body was trembling but without obvious movement) for about 2 weeks, followed by adrenaline rushes for a further 2 weeks, and tiny specks of something resembling yeast on the underside of my tongue.
Would you advise further testing in this instance? If HIV damaged my immune system so quickly as to cause erythematous candidiasis so soon, is it not possible that damage is preventing me from producing antibodies or does it not work that way?
The candidiasis has been confirmed by an oral specialist who has ruled out through what he called systemic blood tests, (3 samples of blood taken), any 'systemic causes'. The infection responds to anti-fungal lozenges but reappears immediately after I finish the course (of nystatin).
I have had 6 4th Generation Hiv tests with the antibody/p24 duo tests in the UK up to 25 weeks. I am still extremely worried that I am a late seroconverter because i know how rare persistant oral fungal infections are in young healthy people, and the joys of searching the internet have informed me that this condition is a common manifestation of HIV.
I realise that getting this condition so soon after infection and then taking longer than 6 months to show up on tests would be very rare - but so is an oral fungal infection with no predisposing factors (anti-biotic or steroid use, diabetes etc).
The only other symptoms I had after the incident came about 4-5 weeks after the incident when I had a kind of inner trembling (it felt like my body was trembling but without obvious movement) for about 2 weeks, followed by adrenaline rushes for a further 2 weeks, and tiny specks of something resembling yeast on the underside of my tongue.
Would you advise further testing in this instance? If HIV damaged my immune system so quickly as to cause erythematous candidiasis so soon, is it not possible that damage is preventing me from producing antibodies or does it not work that way?
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 26, 2007 12:00AM
, Jan 26, 2007 12:00AM
There is no such thing as having HIV despite 4 negative HIV duo tests (or other serological tests of any "generation") through 25 weeks since the last possible exposure. Oral candida sometimes occurs in immunologically healthy persons (I had it myself once), and your bizarre other symptoms aren't suggestive of HIV. Searching the internet is the worst possible way to sort this out.
You don't have HIV. Let it go.
HHH, MD
You don't have HIV. Let it go.
HHH, MD
I'd be shocked if Dr. HHH said anything too different. I hope you can put it to rest after you read his answer.