Need help badly

Doctor,

I have RA and I'am on MTX 2.5 mg.
I had an unprotected oral exposure (receiving) on 01/19/2007 in NY city.

Last week of Feb 2007, I started getting severe headaches and pain allover the neck. I also had some Jaw pain.
Few weeks later my Parotid glands (or my be lymph nodes close to jaw line) on both sides were swollen. And also I had a bump on my right side of neck.

Went for HIV test OraSure (Oral swab test) and was negative on 03/19/2007.

Went to Head and Neck surgeon and got XRAY, MRI done for my neck. Here are my MRI results:

1. Subcentimeter lymph node noted in the spinal accessory region (right side of the neck)
   A similar lymph node is noted on the left. These are not of sufficient size to represent adenopathy.
2. Pratoid and submandibular glands appear within normal limits.
3. Pharynx and larynx appears normal.
4. There are no cervical soft tissue mass or adenopathy.
5. Thyriod gland appears grossly normal.

My doc told me the MRI which can detect very minute things is perfectly normal. Doc referred me to an Oral Surgeon.

Iam I still at risk? This is driving me crazy since 6 months, I don't have any other symptoms other than mentioned above. I still have those symptoms.
The fear of being HIV positive is putting me in doubt that the HIV test done after 90 days may not be right. I'am afraid I did not swipe the swab correctly
around by gums correctly.

Please advice me.

ramhelp

[H. Hunter Handsfield, M.D.]

HIV transmission by oral sex is very rare, and mouth to genital transmission may not occur at all.  Methotrexate therapy, especially in the modest doses used for rheumatoid disease, does not increase the risk of catching HIV and does not delay or otherwise change the results of HIV testing.  The OraSure oral test is almost foolproof; you describe no reason to suspect the specimen was not adquately collected.  On top of all that, there is nothing in your symptoms that suggests HIV as a cause.

Thus, your negative test results prove that the symptoms and other problems you describe cannot be due to HIV.  Most likely your own doctor told you the same thing. But if you remain concerned, bring it up with him or her once again.  If you continue to doubt the OraSure specimen collection, maybe your doctor will retest you with a standard lab-based test to help put your fears to rest.  But truly you can relax.  You don't have HIV.

Good luck--  HHH, MD

[RamHelp]

Forgot to mention:

I get CBC done once in every 2 months because of MTX. It is all normal till now.

[RamHelp]

Thanks for replying to my post.
The only thing that is bothering me is:
Is OraSure sample taken only from gums? or from the cheek too?
Thinking back how I took the sample, I'am sure that I got the sample from lower jaw, swiped around the gums. From upper jaw for sure from the cheek/lip area. When I was taking the sample, I was monitored by the health care professional from our local hospital (Tested as an anonymous).

I believe "mucosal transudate" is abundant from gums and cheek area.

Sorry to bother you with some stupid theory.

Iam visiting an oral surgeon on Wed to see if these are related to TMJ.

Thanking you,
RamHelp

[regularjoey]

Oral swab tests always include internal controls that ensure that the specimen was taken correctly.  I think that's what you're asking.

[RamHelp]

Does that mean, it has some indication if there is not enough sample on the swab?

[regularjoey]

Yes, there is a control band, which represents total IgG I believe.  If the band is absent or too faint the test is invalid.  Yours was negative, not invalid.  Don't worry, people that designed and approved that test took your concern into consideration.

[AloneInhere]

Weird...
I thought the health guy usually is the one who swab you... That is what happen to me...

[RamHelp]

I looked around on web to check if the Oral swab test has any control band and couldnt find any info. I'd appretiate if you can point me to some info.

thanking you,
ramhelp

[RamHelp]

Found this link below:
http://www.orasure.com/uploaded/398.pdf

Looks like a test can be invalid bcos of specimen or device :-) Now, Iam relieved of some tension :-)

Thanks for all you help.
A special appreciation to Dr. HHH, you are doing a wonderful job here.

ramhelp