Very Unusual Case

Doctor, I have never seen a question like this answered before so i hope you can help me. I have had erythematous candidiasis on the roof of my mouth for almost 8 months now. This first occurred roughly 6 weeks following unprotected sex with a female who i learned was very promiscuous yet stupidly had unprotected sex with.
The candidiasis has been confirmed by an oral specialist who has ruled out through what he called systemic blood tests, (3 samples of blood taken), any 'systemic causes'. The infection responds to anti-fungal lozenges but reappears immediately after I finish the course (of nystatin).

I have had 6 4th Generation Hiv tests with the antibody/p24 duo tests in the UK up to 25 weeks. I am still extremely worried that I am a late seroconverter because i know how rare persistant oral fungal infections are in young healthy people, and the joys of searching the internet have informed me that this condition is a common manifestation of HIV.

I realise that getting this condition so soon after infection and then taking longer than 6 months to show up on tests would be very rare - but so is an oral fungal infection with no predisposing factors (anti-biotic or steroid use, diabetes etc).

The only other symptoms I had after the incident came about 4-5 weeks after the incident when I had a kind of inner trembling (it felt like my body was trembling but without obvious movement) for about 2 weeks, followed by adrenaline rushes for a further 2 weeks, and tiny specks of something resembling yeast on the underside of my tongue.

Would you advise further testing in this instance? If HIV damaged my immune system so quickly as to cause erythematous candidiasis so soon, is it not possible that damage is preventing me from producing antibodies or does it not work that way?

[H. Hunter Handsfield, M.D.]

There is no such thing as having HIV despite 4 negative HIV duo tests (or other serological tests of any "generation") through 25 weeks since the last possible exposure.  Oral candida sometimes occurs in immunologically healthy persons (I had it myself once), and your bizarre other symptoms aren't suggestive of HIV.  Searching the internet is the worst possible way to sort this out.

You don't have HIV.  Let it go.

HHH, MD

[peekawho]

Perhaps a different type of anti fungal is needed.  You said you've used Nystatin each time?  There are several different species of yeast, and they don't all respond to nystatin.  

[daveed]

Fluconozole is next to try but i shouldn't have this in my mouth at all which is what is really worrying me.

[peekawho]

The most important info in your post is the fact you've tested out to 25 weeks and are negative.  You do not have HIV, so HIV cannot be the cause of your symptoms.

I'd be shocked if Dr. HHH said anything too different.  I hope you can put it to rest after you read his answer.

[daveed]

Thanks for your comments i just wanted to be sure, my mind is at rest now.