panic - esophagitis

Dear Doctors,

I am in panic now (for other reason). I have read in an article (by John P. Cello, M . D., Ph.D.) that “An acute AIDS esophagitis has been reported in eight patients during the primary infection (ARS).”

Today I went to a Doctor and I was diagnosed with esophagitis which according to him is due to reflux (that is why I have a sore throat). The symptoms started 2 weeks after my exposure (being fingered in my anus, causing great damage, with lots of pre-cum on the finger).

I also read that most doctors say that the most common esophagitis in HIV patients is esophageal candidiasis. Besides, the doctors say it is very difficult to differ between esophageal candidiasis and a simple reflux esophagitis using only endoscopy. Since I did not tell my doctor about my exposure he did not imagine in esophageal candidiasis (and, hence, ask for a culture exam).

In sum, it is not a coincidence to get esophagitis 2 weeks after my exposure. I am scared because I am almost sure I have HIV. Please, help me.

[Edward W Hook, MD]

Welcome to the Forum. I'll try to help. My goal with this response however is to help you get a grip on your unrealistic concerns.  First, anal masturbation (being fingered) is not a risk for HIV, even if it is traumatic and even if there is lots of trauma involved.  Second, unless you failed to say so, you do not know that your partner has HIV.  In fact it is statistically unlikely.  Third, while esophageal candidiasis can occur in early HIV it is VERY, VERY uncommon.  When it does, person typically also have oral Candida (thrush) which is easily diagnosed on examination as well .  I suspect that, despite your concerns, your esophagitis is coincidental.  If you cannot accept my reassurances, go get tested- if you truly have esophagitis related to HIV, your blood test will be positive at this time.  When it is negative, as I am confident will be the case, then accept that you did not get HIV from the no risk exposure that has you concerned.  

Hope this helps.  Let's not go to "what if" questions -they are unproductive.   Take the symptomatic therapy your doctor has almost certainly provided and, if you must get tested. EWH

[Lorenge24]

Doctor, please, answer my question.

[Lorenge24]

Thanks it really makes sense. I am SURE the only way to know is get tested for HIV. No doubts. But just out of curiosity: during the acute sero-conversion, is it common to have a normal CBC? I am asking this because I have just received my CBC and everything is fine (Lymphocytes, Platelet etc.). I only would like to know if it is a reasonable (suggest) indicator that I am not in HIV acute infection.

[Edward W Hook, MD]

There is no useful information to be gained about possible seroconversion from a CBC.  EWH