I AM IN SERIOUS TROUBLE

[Onbendedknee]

Dear HHH

I am a young man ,who was involved with a south african street CSW ( extremely stupid) toward the end of October 2009.

I was wearing a supplied condom but i wound up with two tiny raised bumps on my penile frenulum under the head *Point being my protection FAILED some how. (Slipped (not right off ,was sabotaged perhapse?)

I experienced the following seroconversion illness symptoms:

1) Fever (mild) lasting over a week (Starting at 24hrs after exposure) involving sweating after eating and walking.
2) Oral thrush / furry white patch starting from the back of the toungue and progressing to the tip ( in the afternoon after 1 a half weeks-current) -had been on doxociline + amoxyline (+ stressol + biral -anitdepressents which i anxiously (stupid) over consumed hours prior to the outbreak) I dont know if that is a factor.
3) Joint / muscle pains ( at 2 weeks)
4) Diarhea (at week 2 lasting 4hrs)
5) Lack of appetite (week 6-7)
6) Nausea , fatigue, night sweets (week 7)
7) Painless raised lymph nodes in groin area (week 9 lasting 3 days-at this point the tiny raised yellow bumps under my head started to become less obvious).

I visited the dr on the 4th day (also had a baseline rapid hiv test) and was given antibiotics as he suspected syphilis or hsv / hpv.I was tested for stds after 3 months which came out -VE, but found out that there is no available blood test for hpv .

Ive tested for hiv 1/2  20 times (PCR/ ELISA / RAPID which are negative at 6+ months.

I have not been involved sexually since the incidence with the CSW and dont intend on doing anymore stupid things God help me if i survive this one. however I have since been told on several occasions by some medical practitioners at clinics and some hiv positive people i have encountered that it is not unusual for the window period be 12 months and  even beyond that as experienced in South Africa.I still have a rough burning white patched,stubble feeling toungue.Is there hope?

[Edward W Hook, MD]

Welcome to our site.  Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

I can understand the concerns that you express over the contact the you describe.  Many commercial sex workers in South Africa do have HIV.  HOWEVER, you can be confident that you did not get HIV.  For starters, you used a condom and condoms are highly effective for HIV protection.  If the condom appeared intact, it was.  Condoms do not "leak" just a little.  When a condom fails, it fails completely, breaking side open.  You would have known if it had failed or been sabotaged.  The two "bumps" that you describe, if they are still there are normal, not pathological.  Most importantly, you can be confident that you did not get HIV because of your negative tests.  Any test more that 8 weeks beyond your exposure provides reliable  results and you have multiple tests far beyond that time. You need to believe your tests.

But what about the symptoms you say.  Every one of the symptoms you describe is non-specific and regularly occurs in persons who do not have HIV for a number of reasons.  They by no means suggest that you have HIV.  If the symptoms you are experiencing worry you, discuss them with a doctor but do not worry that the encounter you describe so very long ago gave you HIV, you have proof that it did not and whomever is suggesting that it can take longer than 3 months (or 8 weeks for that matter) to develop a positive test is incorrect and misleading you.

I hope these comments are helpful to you.  EWH

[Edward W Hook, MD]

There are many cuases for leukoplakia.  While it is associated with HIV in some peole, it is not related you your problems because YOU DO NOT HAVE HIV.  This is the last answer to this thread.  You need to be dealing with your anxiety or perhaps guilt and unrealistic fear of HIV, not wasting time and money on furhter testing for an infection that it is proven that you do not have.  

Further questions will be deleted without comment  EWH

[Onbendedknee]

Dr EWK , i have been diagnosed with leukoplakia.I am very much worried about this -but my Dr seems to think it is not malignant.I have had this condition since 1 1/2 weeks after my involvement with the prostitute.Firstly i would like to know if HPV ,antibiotics, hereditary or nutritional circumstances can induce leukoplakia.

My Dr through wanting to put me at ease has drawn my blood for;

1) CD4 + CD8 (count)
2) Eliza (HIV)
3) DNA PCR

I  tested negative 7 1/4 months post suspected exposure on a rapid test.Is it at all possible to test false negative by DNA PCR at 7 3/4 months?

I have expended a lot on this worrisome issue and hope to put it to rest.

[Edward W Hook, MD]

None of what you escrib esuggests HIV or warrants me to modify my advice.

As for the picture, sorry, as a policy we do not look at pictures on this site.  Past experiences have shown us that pictures can be misleading. There is no substitute for direct examination.  If you wish to gain more information about the appeance of your tongue, or for that matter, any other of the skin lesions you describe, I suggest you see your own doctor.  EWH

[Onbendedknee]

Thank you Dr Hook for your analysis.I have been put at ease.Just one last enquiry if you may please:

a) I have uploaded a photograph of my toungue on my profile Albums /Photos just in case it may reveal an underlying serious problem.I have used miconozol and Nystatin on 2 occasions as per pescription  on it without success.

b) The yellow bumps have since shrinked and have become less obvious (paler in colour) -I had been diagnosed with genital warts upon examination at day 4 post exposure?

c) I have been experiencing recuring abcesses (mainly arround the face), {and have also been checked for diabetes=-VE}-, chest, ear infections (worrisome as  i generally enjoy good health) I gather if at all I had hiv it would be too soon to be under attack from opportunistic bacterial and fungal infections?

Thankyou once again DR EWK.

[Ur_overreacting]

You're in the clear, mate! No worries. Regarding HIV, you tested negative at 6+ months. You have absolutely nothing to worry about. You had safe sex to begin with. 3 months is conclusive. You're fine. Test at 12 months just to put your mind 100% at ease. That's the only way. Your result will be negative for HIV assuming you've had no other risks. Again, you're fine ;-) Just stay safe!