Unprotected Intercourse with a POZ women..Strong Symptomes but tests still negative at 12 weeks

Dr HHH I need your wise advice

I'm 32 years healthy male, I have had unprotected intercourse with a women that told me lately that she is poz for 2 years now and she is untreated yet, after 15 days, I had a fever of 37.7 C muscle pain, white tongue and mouth ulcers, diarrhea and blood in stool, Tingling in all my body and a rash on my back, small very painful swollen lymph nodes throughout my whole body (GP diagnostic).I had blood tests at week 12 my CD4/cd8 rate are  nearly  1  ( CD4 count  are 920, DC8 780, a report of 1.20. ) they also found an extremely high rate of CMV IgG, (512 U / ml, the limit is 15 and IgM negative) and high levels of EBV IgG and IgM negative, the doctor thinks they  are for some reason reactivated, and  that the blood in the stool is caused by CMV rectitis. (which happens only in with HIV infected people ).
I did some testing Elisa DUO (HIV1 / 2 and P24).
Week 4 after the risk negative.
Week 6,negative.
Week 9,negative.
Week 10,negative.
Week 12 and negative.

After the negative result of 12 weeks, doctors here in Quebec told me that it was conclusive, I had unprotected sex with my wife after that , after 15 days she had a flu with high fever to 38,5 C, a big fatigue and sore throat with a cough that has persisted more than 3 weeks and a white tongue too.

1- I think that I am a case of a late seroconversion after 12 weeks because of the CMV or the severe neurological, I am right ?

2- My erythrocyte sedimentation rate (ESR) is  very low 1 after 1 and 2 hours, the doctor told me that only HIV and HCV that can make it that slower, is it right ?
2-Why is my CD4/CD8 too low and very high white blood cell if I am not infected ?
3- what other than HIV make EBV and CMV to reactivate? can the stress do that ?
4- Last Question: Should I retest up to 6 months or belive the doctors that I am clear at 12 weeks dispite all evidences that I am ?

Thank you for your valuable help.

[H. Hunter Handsfield, M.D.]

Welcome to the HIV forum.  I'll try to help.

First and by far most important:  You definitely did not catch HIV from your infected partner.  The standard HIV tests in regular use in Canada and most developing countries are 100% reliable when done more than 6-8 weeks (and for sure 12 weeks or more) after the last possible exposure to the virus.  Your test results show you don't have HIV, and that something else is the cause of your symptoms and the various lab test abnormalities.

In addition, all the business about rare false negative blood tests -- if they occur at all -- relates only to the antibody tests.  You also have had a negative p24 antigen test -- and it is impossible to have HIV with both p24 and antibody remaining negative.  For all these reasons, I agree with your Quebec doctors:  you don't have HIV, and you could not have transmitted HIV to your wife.

And it may also reassure you that the chance of catching HIV in this situation was actually quite low.  Obviously one doesn't prefer to have sex with HIV positive partners, and it was extraordinarily inappropriate ane unethical to have had unprotected sex (or any sex at all) without first informing you of her infection.  Still, when a woman has HIV, the approximate average transmission risk is once for every 2,000 episodes of unprotected vaginal sex.  That's why many spouses of HIV infected persons have regular unprotected sex for several years without transmission of the virus.

To your specific questions:

1) As I said, test results always overrule symptoms.  It is far more likely that you don't have HIV at all, than the possibility you have false negative blood tests.  This includes your wife's symptoms, which cannot be due to HIV unless she has had exposures other than sex with you.

2a) I think you are selectively hearing some things your doctors say but not others.  A low ESR is certainly not evidence of either HIV or CMV.

2b) Your CD4 and CD8 are OK because you don't have HIV.  I don't have an explanation for the high WBC, but that's not a sign of HIV.

3) Most people have positive blood tests for EBV and CMV, and the diagnosis of "reactivation" is quite complex.  I have no opinion about whether you have either problem -- but in any case, HIV is not responsible.

4) You should definitely believe your doctors.  If you continiue to have symptoms that concern you, keep working with the doctors to find the cause.  But HIV isn't it.

I hope this helps.  Good luck--  HHH, MD

[Destin32]

Dear Dr Handsfield.

Thank you for your inestimable help, no thing is most relieving that a such words from a worldwide well known expert.

Have one and last question about my CMV and EBV, I have done a colon biopsy they found the CMV infected some regions in my rectal area, and the  PCR for CMV and EBV show high CMV, EBV viral load in the blood. Indeed Its were reactivated. my painful generalized lymph nodes are very small (less than 0.4 inch) but very peripherally generalized, the doctors says that small but painfull lymph nodes is a characteristics that distinguish CMV. My questions are :

a) Can CMV make my tong to be white, mouth canker sore, skin rashes, and tingling in the whole body ?
b) when CMV is reactivated why it make lymph to swell or painfull ? I dont understand, as it was already in the blood but the lymph nodes were note swollen nor painfull.

c) Can CMV and EBV be reactivated because of a very high acute anxiety, is it possible ? or as the doctors suggests that possibly I was exposed to a new strains of CMV and EBV (as I had a french kiss with the infected lady) can that make sens ?

It is was my last questions. I am note worried because of the CMV or EBV reactivation as far as the HIV is not involved. I am back to my life and forgetting about those three black months.

Sorry for my poor english, as I am french speaker. But Juste to mention. I find your help a such extraordinary humain genorosity, thanks very much for your time, and as I am a believer, I Pray GOD to save you for offering time, long expercience and high expertise to aid people in need.

Thank you.

[H. Hunter Handsfield, M.D.]

Thanks for the thanks; I'm glad to have helped.  However, this forum doesn't get into non-HIV conditions, so I have nothing to say about EBV or CMV.   If you have not been evaluated by an infectious diseases specialist, that would be a logical step.

[Destin32]

Dear Doctors.

Following your advice, I visited an ID in a major hospital here in Montreal.
He did some tests and found out that I have OHL, my lymph node are now more enlarged but start to be painless, my CD4 count decreased significantly since my last lab works. My wife are now experiencing generalized swollen lymph nodes, she tests negative for EBV, CMV and all other herpes.

Doctors BOB in the body forum, suggested strongly that a repeat a test a 6 months. And my ID is saying that I have to prepare my self and my wife for eventually bad news in the next 6 months test.
I want just to ask, how can 3,4, 6, 8, 10, 12, weeks Elisa Duo test missed an infection, as apparently my ID and Dr BOB believe that my next test will/could change to positive in 6 months marks.

My immune system is not compromised, I have  not any specific medical situation before. My ID say that there is some medical evidence that in the case of a mutant HIV strain even within HIV-B can make some delay in showing in tests.

1-What should I expect for the next test 6 months mark (within a month) ..My ID disagree to do viral load on me as he say that it could be false negative ( when the virus is under the limit of detection).

2- Why 12 weeks Elisa DUO is not conclusive in my case as some experts are stating ( My HIV ID , including Dr BOB for the body forum), What are our odds for me and my wife to stay HIV- despite the clear evidence that I have it. why my case is such uncommon case .

Thanks

[H. Hunter Handsfield, M.D.]

I continue to believe you do not have HIV; despite your ID doc's opinion, I doubt your 6 month test (or any other test for HIV) will be positive.  However, you should follow his or her advice, and that is the person to whom you should direct questions about your test results up until now.  I will not be drawn into debates with Dr. Bob or any other online authority, but I will point out that his advice and mine almost always are consistent.  If you ever actually have a positive HIV test, please return with a comment to let me know.  But otherwise this thread is closed to new comments.

[Destin32]

Thank you very much for your comments.

I will come back within 6 weeks, to inform you and readers of my and my wife 6 months tests results.

Thanks.

[Destin32]

A related discussion, test results was started.