Opportunistic Infections and HIV

Drs:

Let me preface by saying I am a gay male.  I recently was diagnosed with molluscus contagiosum by a dermatologist.  The pox marks started originally on the lower part of my neck but eventually spread to other parts of my neck as well and even around my chin.  My doctor says this could be a result of shaving.  I received a brochure on molluscus contagiosum and found that it is more common in people that are HIV+.  I also did some research online and found that some lists of opportunistic infections for those that are HIV+ (though not all lists) list molluscus contagiosum. Given that I am a gay male and naturally at a higher risk than the general population, this got me worried.  My most recent HIV test was a week and a half ago, on July 28.  It was for HIV 1/O/2 Antibody test.  The rest result did come back negative.  The last sexual encounter that potentially posed a risk before that was given and receiving unprotected oral about 7 weeks before that.  In particular during that event, I had some problems with oral cavity that made me worried about that event - including but not limited to a canker sore on my lower lip, the likelihood of cuts, and I also suffer my gum disease.  On top of that,nearly immediately after that event I engaged in rigorous use of mouthwash and continued for 2 days, which in turn led to further irritation in my mouth.  

I have three questions, dr.

1.  If an individual has molluscus contagiosum and it is related or caused by being HIV+, is it possible that they are able to still have a false-negative antibody test because they are in the window period?
2.  When does molluscus contagiosum present itself in people that are HIV+?
3.  Do I have anything to worry about?

[Edward W Hook, MD]

Welcome to the Forum.  I can understand precisely how your reading about the subject could raise concerns about the possibility of HIV.  I assure you however, this is not a concern for you.  Let me explain.

HIV is a chronic infection which if untreated, gradually, over a period of years destroys infected persons' immune systems making them unable to fight off or control infections.  When a person’s immunity has been damaged enough, typically after years of infection, they start to get opportunistic infections (OIs).  OIs are called opportunistic because they are infections due to bacteria, viruses and fungus that all of us co-exist with every day but which, in people with damaged immunity, cause diseases that would not occur if our immunity was working better.  

Molluscum contagiousum is a viral infection.,  It is common in normal persons but can be more severe in persons who have damaged immunity such as persons with advanced HIV.  Molluscum is spread by scratching and rubbing among other ways (it is common in normal children).  Shaving is well described to spread molluscum.  

In your case, your negative HIV test 7 weeks ago is VERY strong evidence that you do not have HIV and that your molluscum and its recent spread is more a result of bad luck than anything else.  you have nothing to worry about.

Hope this helps.  EWH

[txman222]

When I refer to "this being a result of shaving" above, I refer to of course the spreading of the molluscus contagiosum from one part of my neck to other parts of my neck and my chin area and not the molluscus contagiosum itself.

Thank you.

[txman222]

Thank you Dr. for your help.  I can infer from your comments therefore that you do not believe further HIV testing is warranted.  Please confirm.  

[Edward W Hook, MD]

Correct.  No further testing needed.  EWH

[txman222]

Hi Dr. Hook.

I don't want to seem like a beating a dead horse, but one thing that occured to me was this.  

I had a canker sore while I performed the oral sex that I referred to above.  In addition, I had another second canker sore that formed sometime in the days that followed.  

I know that canker sores, like molluscus contagiosum, are also more common in those that are HIV.

Does this info lead to any change in your previous advice?

[txman222]

Hi Dr. Hook.

I don't want to seem like a beating a dead horse, but one thing that occured to me was this.  

I had a canker sore while I performed the oral sex that I referred to above.  In addition, I had another second canker sore that formed sometime in the days that followed.  

I know that canker sores, like molluscus contagiosum, are also more common in those that are HIV.

Does this info lead to any change in your previous advice?

[Edward W Hook, MD]

You're beating a dead horse.  No change in my assessment.  Believe the tests. EWH

[txman222]

Dr. Hook -

I'm concerned about my recurrent sores on my mouth as I just have another one that has formed.  Its location is right on the edge of the lip, so I'm not sure if it is another canker sore or perhaps a cold sore.  Does the formation of yet another oral sore - either canker or cold - lead you to question the validity of the advice you gave above and change your previous opinions?  What could be causing this problem?

[Edward W Hook, MD]

Asking the same question again and again will not change my answer.  I am sorry that you are haivng recurrent oral sores.  They are not due to HIV.  If you want to get ttested again you can, of course, do so.  When that test comes back negative will you believe it or not?  My advice is for you to seek the input of an ENT (Ear, Nose and Throat) physician, not to worry about HIV.  EWH

[txman222]

Thank you Dr. Hook.  I just want to make sure that you agree with this generalization that I made.  This will by my last post.  I just need this final issue addressed.

Generalization: "Any sort of ailments that I may experience that sometimes are linked to HIV (ARS, post-ARS, etc) including oral sores ( whether from canker sore, cold sore, leukoplakia, candidasis, etc) are in my case NOT from HIV given the information I provided about my testing from above"

[Edward W Hook, MD]

Do you think that if I say it again it will change meaning?  I said what I meant.  This thread is now over.  You should have moved on long ago.EWH