HIV Testing Accuracy

[anonandanxious]

Greetings,

I realize my question is repetitive, and that it borders on duplicative of the original question I asked, however, I would simply like to discuss my status and symptoms further as to ask for your advice.

In late July of this year I had an unprotected encounter with a female stripper.  She performed brief oral sex on me and may have inserted my penis briefly in her vagina, though the insertion was most certainly brief and not deep.

About 2 weeks after the incident I had a flu-like illness.   This led to my fear that I may have contracted HIV from the encounter.

Since then I have had the following HIV tests, all of which have been negative:

2 weeks: HIV RNA Undetectable, HIV Antibody Negative
4 weeks: HIV RNA Undetectable, HIV Antibody Negative
8 weeks: HIV RNA Undetectable HIV Antibody Negative
12 weeks: HIV Antibody and Antigen Negative
167 days: HIV Antibody and Antigen Negative

Unfortunately, I continue to struggle with "neuropathic" pain -- namely in my mouth (lower gums) and my ankles / lower shins.  It's a tingly sort of pain, with occasional feelings of coldness and vague aches.  I worry that this is peripheral neuropathy related to HIV infection.

My questions:

1) Is there any chance I could have HIV?

2) Does neuropathic damage occur with early HIV infection, as some online resources suggest -- or is it only the effect of either long-term HIV infection OR a very high, early viral load / severe infection.

3) Is there a possibility that I have a rare subtype that is simply not easily detected?

Also, I was tested for Syphillis at 3 months as well via a VDRL test and was negative.  Is this reliable?

I really appreciate your insight.  Thanks.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks.  I'm glad to hear you're getting care.  Speak with your psychiatrist if and when you again feel tempted to have another HIV test.  Best wishes.

[anonandanxious]

Thank you.

I appreciate your response greatly.  

I will mention that I have been visiting with a psychiatrist, and have also started medication for anxiety.  

I simply remain fixated with the fear of undetected infection.  I certainly have to overcome this as to get back to normal.

Thanks again.

[H. Hunter Handsfield, M.D.]

Your questions are indeed duplicative and I'm sure you have predicted the answers.  HIV testing always overrules exposure history and symptoms.  Even if you had a high risk exposure (yours was zero risk) and even if your symptoms were typical of HIV (they are not), your test results prove you are not infected.  To the specific questions:

1) Nope.  No chance.

2) HIV never causes neuropathy as the only symptom.  Even if that were possible, your test results prove HIV isn't the cause of these symptoms.

3) There are no HIV subtypes not detected by the combination of tests you have had.

4) Syphilis testing is 100% reliable any time after 6 weeks.

As implied in many of the replies you received on community forums, I strongly recommend psychological counseling.  It is not normal to have such difficulty accepting such overwhelming evidence, scientific fact, and repeated reassurance.   I doubt you are going to be able to overcome these anxieties by hearing the facts again, or by will power.  I suggest it out of compassion, not criticism.

This forum isn't a substitute for that kind of care, and there is nothing else about your exposure, symptoms, or test results that could possibly change my opinion or advice.  So that will end this thread; I won't have any further comments or advice.

Regards--  HHH, MD