Delayed Seroconversion and ARS

[nervousnelly77]

I had a low risk exposure 51/2 months ago in healthcare. Where a droplet of blood went in to my eye. I rinsed it out but probably not long enough... The patient is a 74 year old man and my boss was laughing at me for being nervous and said that you cant get HIV that way. So I called the PEP hotline and spoke with about 6-7 Drs. all telling me that its such low risk they wouldnt recommend PEP and that even if the patient had HIV the chance of transmission is low risk to nil and that they have never heard of a case with such a small amount causing disease. Anyways, we asked the patient of his status about 4 times and he assured us he was in good health but refused to take a HIV test because he was leaving on vacation... so he said. After the PEP window passed I got very nervous and stressed out. I was convinced that the patient lied and I was doomed. About 8 days later I got loose stools for 2 days, Night sweats for about 2 weeks, Thrush on my tongue, white patches on my tongue, hariy looking papilla and fissures on the tip of my tongue, Burning sensation in my esophagus.And still 5 months later my symptoms persist and more have come about such as numbness in my thighs, sores on my body that are healing slowly, shortness of breath, insomnia and all I can think about is that I know its HIV. Despite all my symptoms all of my tests have been negative thus far.
Oral Swab at 3 weeks- NEG
I had a PCR-RNA test at 36 days- NEG; no virus found; less than 48 copies/100000 ml
Oral swab at 6 weeks- NEG
Antibody test at 12 weeks- NEG
Antibody test at 5 months and 1 week- NEG
Biopsy on skin lesion- NEG
I am hysterical about this. Could pregnancy and extreme stress delay seroconversion? What about Hep C or Latent TB? Are the antibody tests better Now than when the healthcare worker tested pos. 12 months later? HELP

[Edward W Hook, MD]

Final comment.  Some sites are more conservative in their outlook than others. Dr. Handsfield and I have not seen, nor have we heard from any colleague (and we have each asked on multiple occasions at national meetings) of ANY normal person (and we include preganant women among those who are normal) who took more than 8 weeks to develop a positive test in the past two years. If you have HIV, you will be the first among the thousands of person we interact with on this site, among our own patients, or among our colleagues' patients.  take care.  EWH

[nervousnelly77]

I hope you are all right about my negative status...Thus, I vow to donate to AIDS research and I am never working in Healthcare again....This has been a very trying time in my life one that has changed me forever.

[nervousnelly77]

I am not doubting your expertise. I am sure you have gone to numerous CE's and conferences and deal with this all day long. I just want to make sure I get all this off my mind. As there is so much mixed info as in my dental textbooks and online it will drive you nuts. I have tried to stick with the most trusted sites such as med help, the body, and the CDC. I just want to know that if the 3 month window period is for sure why is the workplace exposure regimen have you test out to 1 year? Are there exeptions to this rule and what if I am one of them that is what concerns me...

[Edward W Hook, MD]

Nursegirl is absolutely correct. You have serious misconceptions and misinformation about who gets thrush and the findings and your symptoms are in NO way specific for HIV.  You have all the information you need to be 100% confident that you do not have HIV at this time and do not need further testing.  EWH

[nursegirl6572]

You keep saying over and over that thrush is "automatically" related to HIV, and you KNOW this b/c you are a dental hygenist?  Honey...I have news for ya...if you and your dental crew automatically assume that every patient that presents with thrush has HIV...then you ALL need more schooling.  YOU NEED TO LET GO OF THAT AND MANY OF YOUR MISCONCEPTIONS.

In any given day....approx 1/4-1/3 of patients in our facility have thrush (and that is a LOW guesstimate).  There are MANY many many causes.  Antibiotics cause thrush, smoking causes thrush, poor dental/oral hygeine...just to name a few.  If you have thrush......MOST likely it is caused by your PREGNANCY!  (Which, btw, is another reason a person can have thrush).

You have received the very best advice on this thread from the very patient doc...get yourself some help from a mental health professional.  It is NOT reasonable to not be able to accept that you do NOT have HIV despute such overwhelming evidence that you do not.  HIV tests these days are VERY sensitive...they pick up infection VERY early on.  You do NOT have HIV.  Celebrate that fact and get yourself some help.

I'd make you a bet that as SOON as you start harnessing your anxiety...your mysterious "symptoms" will resolve on their own.  ANXIETY causes very real physical symptoms.

[nervousnelly77]

I am just concerned because I am pregnant and I am doing everything I can for the safety of my baby. I know that symptoms cannot be ignored. In general, when symptoms persist one would go to the DR. for a diagnosis. I know that my oral health conditions are HIV specific because I am a dental hygienist. Most Docs I have seen automatically assume HIV when I mention Thrush. That is why I have been so insane over this. I want to let this go but I can't just yet. Do you have any other suggestions? I know I need therapy to mend my emotional wreckage but are there any other HIV tests or blood tests I should take for 100% peace of mind? And is delayed serconversion really an urban myth? there are always exceptions to the rule.
  

[Edward W Hook, MD]

Please see my answer above.  There are any number of possible reasons for your symptoms, all of which are non-specific.  To my knowledge, the only thing you have effectively ruled out is HIV.  It is now time for you to work through this with a health professional and perhaps a mental health professional focusing on possible causes other than HIV.  I wish you luck at that- it will help. EWH

[joggen]

This forum cannot help you. Talk to a counselor or a psychiatrist about what is going on with you.

[nervousnelly77]

PLEASE ANSWER!!!!!!!

[nervousnelly77]

How would you explain these strange symptoms if it is not HIV? How can you be so sure it is not HIV? I am going nuts....I am on an emotional roller coaster of negative test results but persistant symptoms specific to HIV...

[Edward W Hook, MD]

Relax.  You clearly do not have HIV. Your tests prove this repeatedly. The concept of "delayed seroconversion" is an urban myth with no meaningful data to substantiate it.  Pregnancy does not change this.  You do not have HIV- period.  

Your stress is your problem. you are letting this exposure eat you alive.  What you need is not testing or medications for an infection you do not have but help working through this.  If you are having trouble doing this yourself, I urge you to seek the help of a mental health professional.  I hope this comment helps- it is intended to.  EWH

[nervousnelly77]

I have heard that only very critcally ill people test after the 3 month window period but how ill would a person have to be?