Doctors, Please Help Me... I'm Struggling

Hello Doctors,

Please help me.  I'm hurting emotionally and crying every night out of fear.  My fear is I got vaginal secretions in an open wound on my hand at an exotic dance club.  Here is a breakdown of where I'm at.  12 weeks ago tonight is when this occurred.  I have had several tests done and will state them and the results.
At 13 days past possible exposure I went to the doctor and had a CBC and SED Rate done.  The doctor said everything was normal and my WBC was 5800, my absolute lymphocyte was 1038, and my lymphocyte count was 17.9%.
- At 20 days past possible exposure I had a HIV 1/2 EIA done - result negative
- At 32 days past possible exposure I had the following done:
HIV 1/2 ELISA - result negative
PCR DNA Test - Result was non-reactive (negative)
- At 53 days past possible exposure I had another HIV 1/2 EIA done - result negative

Somewhere around 25 -30 days past possible exposure I started getting jaw pain and some dry mouth.  Around 50 days past possible exposure the dry mouth got very bad and my tears became thicker and decreased in amount drastically. (I've been upset about this for 3 months because I'm worried I messed up my and my finances future.

The dry mouth continues and in trying to find the conclusiveness of my tests stumbled on info that freaked me out.  I saw on Quest Site (I used LabCorp) that PCR DNA could be false negative due to low lymphocytes.  I then looked up normal lymphocyte counts and realized I am on the low side of normal, but not low (I think).  Anyway, my questions are this:

1 - Are my test results at this point conclusive? Do the results of my CBC make them less accurate?
2 - If my dry mouth, sometimes eyes, and today starting sore joints, were due to Diffuse Infiltrative Lymphocytosis Syndrome would my tests have been positive?  Can something like that occur this early?

I'm sorry, I'm just very scared about the future of my fiancé and I.  I know I can get a 12 week test, but I have seen posts where you say this is not necessary, so I was hoping not to.  

Thank you.

[H. Hunter Handsfield, M.D.]

Welcome -- but this question should be in the HIV Prevention and Safe Sex Forum; this forum is limited to STDs other than HIV.  I'll see if it can be moved.   The news is good, through:  your test results are definitive.  You do not have HIV and have been worrying needlessly.

You had a zero risk exposure; scan or search other threads for other discussions of fingering with or without wounds on the fingers or hands.  This is true even if the woman involved has HIV -- which, if you are in the US, is statistically very unlikely.  As for your symptoms and your CBC results, there is nothing that suggests HIV.

Most important, your HIV blood tests are 100% proof you weren't infected.  You do not need any more tests at 12 weeks or any other time.  The common advice for final testing at 3 months applies only when antibody tests are the only ones done.  With negative PCR as well as antibody, your negative results are definitive.  See the thread linked below.

http://www.medhelp.org/posts/show/1704700

Your blood count was basically normal, and your lymphocyte count is not significantly low -- but in any case, you are wrong about low lymphocytes affecting HIV test performance.  But even if it were not, even if your symptoms were typical for HIV, and even if you had a true high risk exposure, it wouldn't matter.  The HIV tests are among the most accurate diagnostic tests ever developed and the results overrule all other factors.

Those comments answer your questions -- but to be explicit so there is no possibility of misunderstanding:  1) Your HIV test results are conclusive.  2) Those symptoms are not even close to what is expected in people with HIV.  Something else is the cause.

I would bet your doctor has told you pretty much the same thing.  You really need not be at all worried, and you should be continuing unprotected sex with your fiance with no worry about infecting her.

I hope this has helped resolve your fears.  Best wishes --  HHH, MD

[PleaseHelpMe444]

Doctor, thank you for taking the time to answer my question, it definitely helped.  I do have a few follow up questions for you though, just because I guess I don't understand what I have read in other places.

1 - Why do sites like TheBody talk so negatively about PCR DNA tests when you say they, when coupled with an antibody test, are conclusive after 4 weeks?  

2 - Have you ever seen, read, or heard of someone having a negative PCR DNA & Antibody test after 32 days (or more than 4 weeks) that later tested positive?  Even if they had a negative antibody test at 7 1/2 weeks?

3 - As mentioned in my original questions/post my symptoms have been jaw swelling for about 2 months, a dry mouth that has gotten progressively worse, drying eyes, and now some elbow and knee joint pain.  When I was freaking out and googling things I came across DILS and HIV SGD, which these symptoms seemed to match, which freaked me out more.  My question is A.) Can those diseases occur so quickly after a possible infection?  I read somewhere that they can present in an early HIV stage or be the initial presentation of infection? B.) Had my symptoms been from one of those, would I have had to have had a positive antibody test result during one of the tests I had?

Thank you so much for this great service you provide, and your assistance to me in this time.

[H. Hunter Handsfield, M.D.]

1) I don't know what negative vibes they describe on TheBody about PCR tests.  The main problem is when they are used in low risk situation, in which case a modest number of results are falsely positive.

2) No, I have never heard of such a situation.  It's a pretty much impossible one.

3) Regardless of any symptoms or seemingly HIV-related complications you have had, the negative HIV tests prove you do not have HIV.  Period.  Believe the tests and continue to work with your doctor about any continuing symptoms you have that concern you.  They have nothing to do with the non-exposure event you have described -- except that some may be physical manifestations of anxiety about it.

That will end this thread.  Do your best to accept the reasoned, science based reassurance you have had, and the test results.  If you find yourself still upset and worried, the next step should be professional counseling.  Your emotions and overall reactions to this event are far outside the normal levels of stress and anxiety that most people would experience.