panic - esophagitis - ARS HIV

Dear Doctors,

I am in panic now (for other reason). I have read in an article (by John P. Cello, M . D., Ph.D.) that “An acute AIDS esophagitis has been reported in eight patients during the primary infection (ARS).”

Today I went to a Doctor and I was diagnosed with esophagitis which according to him is due to reflux (that is why I have a sore throat). The symptoms started 2 weeks after my exposure (being fingered in my anus, causing great damage, with lots of pre-cum on the finger).

I also read that most doctors say that the most common esophagitis in HIV patients is esophageal candidiasis. Besides, the doctors say it is very difficult to differ between esophageal candidiasis and a simple reflux esophagitis using only endoscopy. Since I did not tell my doctor about my exposure he did not imagine in esophageal candidiasis (and, hence, ask for a culture exam).

In sum, it is not a coincidence to get esophagitis 2 weeks after my exposure. I am scared because I am almost sure I have HIV. Please, help me.

[Dr. Jose Gonzalez-Garcia, MD, MRCGP, PhD]

Hello,
Thank you very much for your post and welcome to our forum.
First of all, I would like to say that your sexual encounter was very low risk and would very much doubt that you have been infected that way.
Secondly, candidial oesophagitis happens mainly many years after the initial infection and not after 2 weeks.  It is extremely rare during acute sero-conversion and I do not think this is your case.  The most common cause is gastric reflux and I am sure this is your problem.  Stress and anxiety can be a trigger for this.  You could take a proton-pump inhibitor like omeprazole; if symptoms resolve, this would confirm that your symptoms are caused by gastric reflux and not by Candida.
The best way to reduce your fears is by having a HIV test.  You could have a PCR RNA test now, or a HIV Duo test after 4 weeks of the sexual encounter.  I am sure that the results will be negative.
Best wishes,
Dr José

[Lorenge24]

Just one more question. I am sure the only way to know is get tested for HIV. But just out of curiosity: during the 2-4 weeks acute sero-conversion, is it common to have a normal CBC? I have just received my CBC and everything is fine (Lymphocytes, Platelet etc.). I only would like to know if it is a good indicator that I am not in HIV acute infection.