Testing Question - OHL Symptom(s)

[itwasntme]

Dear Dr's:

I've read a lot on this forum and finally got the courage to post my question.  I am a 34 yr old male that has had 7 partners since I was 15.  I don't feel any of these individuals were necessarily high risk but I did decide to get tested last year after some strange oral/dental issues for the past 6 mos which include:

1 - dry mouth
2 - white cheeks (that do not scrape)
3 - a single white line about 1/8 inch on each side of tongue (some times gets worse if I really pick/scrape at it)
4 - Arthritic type pain in my left hand

Obviously my concern is OHL Not too many Dr''s know about this disease so I thought I'd ask you given this is almost exclusively seen with HIV.

Questions:

1 - Are my 3rd generation negative antibody tests 100% conclusive at 18 weeks post any sexual encounter?  Should I worry about lab mistakes at a minimum given my symptoms above?

2 - Would OHL migrate and change over time based on your knowledge?  Meaning - get better, worse, move around the mouth on a weekly sometimes daily basis but never go away?

3 - Would 2 vertical ridges no more than 1/8 inch (one on each side) with accompanies dry mouth be suggestive of OHL based on your experience?

4 - I have candy (one on each side) in my mouth 24/7 (even as I sleep) to promote saliva and get rid of dry mouth.  After I started doing this is when I got white spots/wrinkles in my cheeks.  Is there any chance that this could be causing leukoplakia like symptoms (not necessarily oral hairy but regular leukoplakia common to smokers or those who cheek bite).  I was wondering if candy resting against your cheek (in your medical opinion) 24/7 could be considered "a constant irritant" similar to what causes leukoplakia in smokers, cheek biters & people with poor fitting dentures.

The funny thing is I had 0 symptoms until 19 weeks  which was a few days after my negative result.  I'm now on lexapro for my anxiety which I cannot shake.

Thank you very much for answering my specific questions.

[H. Hunter Handsfield, M.D.]

Welcome fo the HIV forum.

You have no worries.  First, HIV test results always outweigh symptoms in judging whether or not someone has HIV.  There are no exceptions as long as testing is done long enough after exposure -- and 18 weeks is plenty.  Even 6-8 weeks usually is adequate.  Therefore, the details of your oral symptoms are irrelevant:  the negative HIV test proves something else is the cause.  On top of that, OHL related to HIV is evidence of overt AIDS, and occurs only in people with other symptoms -- usually fever, weight loss, and generally being quite ill.  Finally, self-diagnosis of OHL by medically untrained people really isn't possible.  It is very unlikely that OHL explains your oral symptoms.

I think that answers all your questions.  Briefly, the specific replies are:

1) Yes, 100% conclusive.

2,3) I cannot answer based on written description.  It's very doubtful you have OHL.  You need to see a health care provider in person to know the cause of these symptoms.

4) Sugar also gives a "wrinkly" feel to my cheeks when I such on hard candy.  This doesn't sound abnormal.  But I cannot reply from a medical standpoint, except to say this doesn't suggest HIV to me.

See a provider if you remain concerned about your oral symptoms. But you can disregard HIV as a cause.  It isn't possible.

I hope this helps.  Best wishes--  HHH, MD

[itwasntme]

Dr  - Thanks for the response.  I have been seeing a girl for about 6 months now which is now 8 months after my test and 12.5 months since my last sexual encounter other than giving oral and condom protected vaginal sex.  Based on the symptoms above and based on my test results, test type and test timing do you feel it is okay for us to engage in unprotected sex?  She tested for my benefit and assuming she's been faithful did so 4 months after her last unprotected sex.

To reiterate my symptoms:

1 - Dry Mouth

2 - White tongue/cheeks - tongue doesn't resemble OHL and no pictures on net of cheeks infected for me to compare to.   Tongue and cheeks go back to pink and smoothe when sucking on candy.

3 - Little tiny mouth ulcers

Things I do:  suck candy/cough drops 24/7 and brush the hell out of my teeth, gums, cheeks, tongue.  I'm afraid to stop these things because when I do my mouth is all messed up.  I notice I chew on my tongue at night as it wakes me up.  It is not painful at all but does wake me up as I notice that I am pushing my tongue against the roof of my mouth hard and my teeth are pressed against the outer border of my tongue.  I even have what appears to be ridges along the top border and lateral border of my tongue that line up exactly with my teeth.  

All of these symptoms have come and gone in levels of severity over the last 8 months.  And ironically didn't even start until after I got my negative result!!!!

Thank you again for your advice.  I just don't want to spread this disease and I want to take control of my life back.  

[H. Hunter Handsfield, M.D.]

This information does not change my opinion or advice.  You do not have HIV.  See a provider if you remain concerned.