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Repost - HIV and Herpes - link to original post not working
Dr.-
I had vaginal sex with a csw (from ukraine) in the US. The condom broke. Only time I’ve done this. Summary:
1)Potentially swollen back of neck lymph node and swollen stomach skin lymph nodes per doctors. Slightly sore armpit edges
2)Fatigue after week 1 but done by week 2. One dizziness episode at day 15 where I was forced to sit down
3)Abdomen pain for 4 weeks (Starting day 14). RNA PCR (Roche) and P24 done on day 14 – both negative. Abdomen pain presents itself as shocks/tingling all around abdomen and centered around belly button. There is also a gnawing pain mostly on the left and right side (vertically) of my abdomen
4) Irritated throat (but it wasn't sore) for 3 weeks. I noticed a couple of blood spots on my uvula and next to it when the throat irritation started to clear. I thought excessive heating was the cause
5)Week 6 HIV test negative. Abdominal CT at week six doesn’t show anything abnormal; pain still present
Questions:
1) Given my symptoms, what do you think of the 6 week result? Repeat at 8 weeks?
2) I'm also getting slight tingling in my legs/groin. I had a day where my hips were "burning" when I was laying on my side. Could herpes cause something like this without blisters being present?
3) Could the azithromycin have caused my stomach issues? The pain started exactly a week after my initial dose.
4) Is doing a DUO test at 7 weeks too late?
5) See labs below, is the drop in platelets in week 6 abnormal? Is the drop in lymphocytes from my old “2004 norm” of 1700 significant?
Labs:
2004 -10 AM
WBC 7000
Platelet 234
Neutro 66% (abs 4600)
Lympho 25% (abs 1700)
Week 2 - 9 AM
WBC 7600
Platelet 217
Neutro 77% (abs 5900)
Lympho 16% (abs 1200)
Week 3 - 3 PM
WBC 8100
Platelet 231
Neutro 74% (abs 5980)
Lympho 17% (abs 1380)
Week 4 - 2 PM
WBC 7100
Platelet 227
Neutro 69% (Abs 4910)
Lympho 21% (Abs 1520)
Week 6 - 9 AM
WBC 6190 (ref range 3280–9290)
Platelet 187 (ref range 143-398)
Neutro 67% (abs: 4200)
Lympho 21% (abs: 1300)
I had vaginal sex with a csw (from ukraine) in the US. The condom broke. Only time I’ve done this. Summary:
1)Potentially swollen back of neck lymph node and swollen stomach skin lymph nodes per doctors. Slightly sore armpit edges
2)Fatigue after week 1 but done by week 2. One dizziness episode at day 15 where I was forced to sit down
3)Abdomen pain for 4 weeks (Starting day 14). RNA PCR (Roche) and P24 done on day 14 – both negative. Abdomen pain presents itself as shocks/tingling all around abdomen and centered around belly button. There is also a gnawing pain mostly on the left and right side (vertically) of my abdomen
4) Irritated throat (but it wasn't sore) for 3 weeks. I noticed a couple of blood spots on my uvula and next to it when the throat irritation started to clear. I thought excessive heating was the cause
5)Week 6 HIV test negative. Abdominal CT at week six doesn’t show anything abnormal; pain still present
Questions:
1) Given my symptoms, what do you think of the 6 week result? Repeat at 8 weeks?
2) I'm also getting slight tingling in my legs/groin. I had a day where my hips were "burning" when I was laying on my side. Could herpes cause something like this without blisters being present?
3) Could the azithromycin have caused my stomach issues? The pain started exactly a week after my initial dose.
4) Is doing a DUO test at 7 weeks too late?
5) See labs below, is the drop in platelets in week 6 abnormal? Is the drop in lymphocytes from my old “2004 norm” of 1700 significant?
Labs:
2004 -10 AM
WBC 7000
Platelet 234
Neutro 66% (abs 4600)
Lympho 25% (abs 1700)
Week 2 - 9 AM
WBC 7600
Platelet 217
Neutro 77% (abs 5900)
Lympho 16% (abs 1200)
Week 3 - 3 PM
WBC 8100
Platelet 231
Neutro 74% (abs 5980)
Lympho 17% (abs 1380)
Week 4 - 2 PM
WBC 7100
Platelet 227
Neutro 69% (Abs 4910)
Lympho 21% (Abs 1520)
Week 6 - 9 AM
WBC 6190 (ref range 3280–9290)
Platelet 187 (ref range 143-398)
Neutro 67% (abs: 4200)
Lympho 21% (abs: 1300)
MEDICAL PROFESSIONAL
I recommend you not do that. It is exceedingly unlikely there is anything you could add that would change the opinion and advice you have had.
Appreciate your help. No more questions. I'll post a new thread and pay again if i have further questions.
MEDICAL PROFESSIONAL
The additional details of the exposure make no difference; the test results prove you weren't infected. Your lymphcyte count is not significantly low, and as I already said, the HIV test results prove you don't have it. No medical condition makes HIV testing falsely negative or delays positive test results, except possibly for very potent chemotherapy or immunosuppressive drugs, and immediately life-threatening illnesses like terminal cancer -- and even these are only theoretical, with few if any actual known cases of causing false negative HIV tests.
As I said, if your symptoms continue and are bothersome, continue to work with your doctors about the the cause and possible treatment. But please put HIV out of your mind. It is simply not a possible explanation for them.
As I said, if your symptoms continue and are bothersome, continue to work with your doctors about the the cause and possible treatment. But please put HIV out of your mind. It is simply not a possible explanation for them.
Thank you so much doctor. I was concerned that 14 days was too early for the p24 and RNA tests.
The nature of the exposure was a CSW. The condom broke and i was exposed for a minute or so. I think it broke because she was a little dry. Not thinking, i slipped on another condom without washing off or stopping altogether. i only washed off when i got home and i am uncircumcised. when the event occured, she ran into the bathroom to wash off. When i was leaving, i asked about std's and she said no that she didn't have any, but then said she'll get a bacterial test done. I called back they next day to ask for the hiv/std status, and the person got very upset and said she didn't ask me about my health and its private. then proceeded to say "yes yes hiv positive and i get tested every month and everything is normal." So bottom line is i don't know what was true on hiv status. Furthermore, she has been in the country for 3 months and was previously in the baltic states which i believe has a higher hiv infection rate currently.
I was also wondering if my lowered lymphocyte counts may delay my antibody production (sorry, i was an immunology undergrad so this is really getting to me). 1200 TLC seems to be a proxy for initiating HAART in developing nations so that got me concerned as well. Also, i've been working 12-17 hours a day under high stress for the past year so not sure if my immune system has suffered a bit b/c of that.
I was mostly concerned b/c the tingling continues at almost 7 weeks out and the stomach pain is still there. i have never felt anything like this in my abdomen and i usually never go to the doctor.
Thanks again for your help and hope that you are enjoying the holidays.
The nature of the exposure was a CSW. The condom broke and i was exposed for a minute or so. I think it broke because she was a little dry. Not thinking, i slipped on another condom without washing off or stopping altogether. i only washed off when i got home and i am uncircumcised. when the event occured, she ran into the bathroom to wash off. When i was leaving, i asked about std's and she said no that she didn't have any, but then said she'll get a bacterial test done. I called back they next day to ask for the hiv/std status, and the person got very upset and said she didn't ask me about my health and its private. then proceeded to say "yes yes hiv positive and i get tested every month and everything is normal." So bottom line is i don't know what was true on hiv status. Furthermore, she has been in the country for 3 months and was previously in the baltic states which i believe has a higher hiv infection rate currently.
I was also wondering if my lowered lymphocyte counts may delay my antibody production (sorry, i was an immunology undergrad so this is really getting to me). 1200 TLC seems to be a proxy for initiating HAART in developing nations so that got me concerned as well. Also, i've been working 12-17 hours a day under high stress for the past year so not sure if my immune system has suffered a bit b/c of that.
I was mostly concerned b/c the tingling continues at almost 7 weeks out and the stomach pain is still there. i have never felt anything like this in my abdomen and i usually never go to the doctor.
Thanks again for your help and hope that you are enjoying the holidays.
MEDICAL PROFESSIONAL
As I said above, there was sufficient information in the opening field to answer accurately. On quick scan of this additional information, there is nothing in it that changes my opinion or advice above. For sure you don't have HIV, but that's as far as this forum goes, so I won't speculate about other causes. The negative RPR also proves you don't have syphilis, which I would not have suspected anyway, based on your symptoms.
MEDICAL PROFESSIONAL
The same question was deleted in the STD forum because HIV related questions belong in this forum; and more important, it was (and remains) far too long. The 2,000 character limit is intended to force all new questions to be posted in the original field; it it not permitted to spill over into a comment window. The moderstors do not have the time and energy to read such long essays!
This reply responds only to the information in the initial window above. There is enough information in the first part above (before all the lab results) to answer accurately, regardless of all the clinical detail you provide in the comment window below.
You had a relatively low risk exposure, since even if your partner had HIV, the transmission risk from a single episode of vaginal sex averages about 1 in 2,000. More important, If HIV testing is done sufficiently long after the last possible exposure, the test results outweigh everything else. Your test results prove you didn't catch HIV. Your symptoms and the other lab results make no difference. To the numbered questions:
1,2) The standard antibody tests are almost always positive by 6 weeks, and the combination of two negative HIV viral tests (p24 antigen and PCR) plus your several negative antibody prove you do not have HIV. Something other than HIV is the cause of your symptoms -- which don't sound much like a new HIV infection anyway. They also do not sound like an initial herpes infection, and most likely are not related to your sexual exposure in Ukraine, just a coincidence of timing.
3) Azithromycin often causes gastrointestinal symptoms, but only within the first few hours of taking it.
4) The Duo test is always positive by 4 weeks and never again turns negative. There is no such thing as doing a Duo test (or any HIV test) too late.
5) All the lab tests below are entirely normal. The different values from day to day are within the range of both normal variation and the precision of the tests themselves.
Most likely you have been told the same things by your own health care provider(s). Please believe them. Continue to follow his or her advice about additional evaluation if your symptoms persist.
Regards and best wishes for happy holidays-- HHH, MD
This reply responds only to the information in the initial window above. There is enough information in the first part above (before all the lab results) to answer accurately, regardless of all the clinical detail you provide in the comment window below.
You had a relatively low risk exposure, since even if your partner had HIV, the transmission risk from a single episode of vaginal sex averages about 1 in 2,000. More important, If HIV testing is done sufficiently long after the last possible exposure, the test results outweigh everything else. Your test results prove you didn't catch HIV. Your symptoms and the other lab results make no difference. To the numbered questions:
1,2) The standard antibody tests are almost always positive by 6 weeks, and the combination of two negative HIV viral tests (p24 antigen and PCR) plus your several negative antibody prove you do not have HIV. Something other than HIV is the cause of your symptoms -- which don't sound much like a new HIV infection anyway. They also do not sound like an initial herpes infection, and most likely are not related to your sexual exposure in Ukraine, just a coincidence of timing.
3) Azithromycin often causes gastrointestinal symptoms, but only within the first few hours of taking it.
4) The Duo test is always positive by 4 weeks and never again turns negative. There is no such thing as doing a Duo test (or any HIV test) too late.
5) All the lab tests below are entirely normal. The different values from day to day are within the range of both normal variation and the precision of the tests themselves.
Most likely you have been told the same things by your own health care provider(s). Please believe them. Continue to follow his or her advice about additional evaluation if your symptoms persist.
Regards and best wishes for happy holidays-- HHH, MD
Day 0: Came home and washed penis and urethra with soap. Didn’t even know about PEP so didn’t go to ER.
Day 3: Slight burning on urination
Day 5-7: Pretty tired and had headache. Notice swelling inside urethra and continuation of burning.
Day 6: Fever of 100, took Advil.
Day 7: Went to STD clinic. Fever in the 99.5 range...given azithromycin (1gram) for gon/chlamidya PEP. The Doc said he didn’t think it was Herpes since my symptoms showed on the urethra and he didn’t see the typical blisters.
Day 8: Penis is sticky, I thought maybe from the azithromycin. Got a swab and a PCR done for HSV, both come back negative.
Day 9: Night sweat where it was pretty wet
Day 10: Get sharp pain in back of my neck as I was getting up and it resulted in a bump on the back of my neck. As soon a s the pain hit, it radiated to the back of my skull on the right side and I got a headache. The bump is still there on my neck one month later, although it’s smaller. A couple of physicians have said it's a node, a muscle, or a nerve (I’ve been traveling so visited a couple of different physicians). I’m not sure what it is. I don’t feel anything under it. I have a permanently swollen lymph node on my neck since childhood that is very well defined and it feels like a rubbery node inside, but this doesn’t feel anything like that. At its max, this swelling was 1.5cm in diameter and raised up and almost a perfect circle at its max size 2 weeks later.
Day 14: Sharp pain begins in my stomach area one inch under my ribs on both the left and right side. It appears for a few seconds and it disappears and feels like it is in my skin.
Day 15: Stomach pains increase throughout my abdomen (especially belly button) with sharp tingling sensations. Pain level is probably 2-3, but they are quick and go away with a couple of seconds for the most part. But when they start, it’s like a rapid firing in the different areas. Intestines are also making extremely loud gurgling sounds. I notice a couple of lumps in my stomach skin that hurt when they get pressed. I put a heating blanked on my stomach for a couple of days which seems to help the pain and the sensations.
Day 19: Stomach sensations continue and I also have pains in the center of my chest and my upper right chest area. As a result, I go to the ER. ER Resident says that the lumps in my stomach are lymph nodes and that I have a swollen lymph node on the back of my neck. The attending comes in and does a quick once over and says there are no swollen nodes and doesn't really answer my question on what the neck bump is - he tells me to go the acute care clinic since this isn’t an “emergent” condition. They gave me prilosec b/c they thought I also had GERD when I described my increased belching over the past year.
Day 21: abdominal ultrasound comes back normal expect for a slightly fatty liver and a renal cyst. I don’t think they checked for swollen lymph nodes in abdomen.
Day 28: Stomach pain is still present but slightly less, but the belching is reduced thanks to prilosec. My intestinal area still hurts when the pain comes, especially right below the belly button. I notice that it doesn’t hurt when I put a lot of pressure on it, but if I just rest my hands on my stomach, then the skin starts to hurt. The pain also gets worse when i sit up in the car for an hour or so. Doc said there is no swelling of the organs.
Day 42 (Week 6): HIV and RPR are negative. Abdominal ct scan didn't show enlarged lymph nodes (greater than 1cm) or any other abnormalities.
Day 47: Today. Stomach pain seems to be in the skin and feels like little shocks – it’s hard to describe it.
-Craig
Day 3: Slight burning on urination
Day 5-7: Pretty tired and had headache. Notice swelling inside urethra and continuation of burning.
Day 6: Fever of 100, took Advil.
Day 7: Went to STD clinic. Fever in the 99.5 range...given azithromycin (1gram) for gon/chlamidya PEP. The Doc said he didn’t think it was Herpes since my symptoms showed on the urethra and he didn’t see the typical blisters.
Day 8: Penis is sticky, I thought maybe from the azithromycin. Got a swab and a PCR done for HSV, both come back negative.
Day 9: Night sweat where it was pretty wet
Day 10: Get sharp pain in back of my neck as I was getting up and it resulted in a bump on the back of my neck. As soon a s the pain hit, it radiated to the back of my skull on the right side and I got a headache. The bump is still there on my neck one month later, although it’s smaller. A couple of physicians have said it's a node, a muscle, or a nerve (I’ve been traveling so visited a couple of different physicians). I’m not sure what it is. I don’t feel anything under it. I have a permanently swollen lymph node on my neck since childhood that is very well defined and it feels like a rubbery node inside, but this doesn’t feel anything like that. At its max, this swelling was 1.5cm in diameter and raised up and almost a perfect circle at its max size 2 weeks later.
Day 14: Sharp pain begins in my stomach area one inch under my ribs on both the left and right side. It appears for a few seconds and it disappears and feels like it is in my skin.
Day 15: Stomach pains increase throughout my abdomen (especially belly button) with sharp tingling sensations. Pain level is probably 2-3, but they are quick and go away with a couple of seconds for the most part. But when they start, it’s like a rapid firing in the different areas. Intestines are also making extremely loud gurgling sounds. I notice a couple of lumps in my stomach skin that hurt when they get pressed. I put a heating blanked on my stomach for a couple of days which seems to help the pain and the sensations.
Day 19: Stomach sensations continue and I also have pains in the center of my chest and my upper right chest area. As a result, I go to the ER. ER Resident says that the lumps in my stomach are lymph nodes and that I have a swollen lymph node on the back of my neck. The attending comes in and does a quick once over and says there are no swollen nodes and doesn't really answer my question on what the neck bump is - he tells me to go the acute care clinic since this isn’t an “emergent” condition. They gave me prilosec b/c they thought I also had GERD when I described my increased belching over the past year.
Day 21: abdominal ultrasound comes back normal expect for a slightly fatty liver and a renal cyst. I don’t think they checked for swollen lymph nodes in abdomen.
Day 28: Stomach pain is still present but slightly less, but the belching is reduced thanks to prilosec. My intestinal area still hurts when the pain comes, especially right below the belly button. I notice that it doesn’t hurt when I put a lot of pressure on it, but if I just rest my hands on my stomach, then the skin starts to hurt. The pain also gets worse when i sit up in the car for an hour or so. Doc said there is no swelling of the organs.
Day 42 (Week 6): HIV and RPR are negative. Abdominal ct scan didn't show enlarged lymph nodes (greater than 1cm) or any other abnormalities.
Day 47: Today. Stomach pain seems to be in the skin and feels like little shocks – it’s hard to describe it.
-Craig
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