Can I Rest with this Result? Still have dx'd Thrush

[regretfulSOB]

Hey Doc, Im having a hard time reaching closure with this my symptoms are as follows:

exposure:  unprotected vaginal sex (30 min) w/no ejaculation with random girl in Vegas 2 hours after meeting her, didn't look like an IVDU but I remember her saying she was from San Francisco

0-2 weeks:  didnt' stress about it too much, penis started to itch, had small hpv lesion appear (had it 1 time before)

day 14:  Full STD Panel because I started dating someone special (all negative), afternoon after STD panel ARS:  chills, fever, nightsweat, abdominal pains, diarrhea, white tongue, frequent urination, urethritis (HIV WASNT A THOUGHT IN MY MIND)

day 18:  felt fine, other than urethritis, difficulty urinating, went to ER, prescribed Flagyl, urine clean

days 19-23:  groin pain, tingling, dry mouth, 2 days of diarrhea (not sure if it was the Flagyl), by the way, don't ever drink on it

day 25:  went to respected urologist, he gave me 3 week doses of doxy, cipro and levaquin for NSU, high doses from what I could tell, also gave me condylox (it worked for 1 small hpv after 4 days)

days 26-31:  nsu started clearing up with meds, chills and cold night sweats; discovered NIGHTSWEATS+white tongue = HIV, thought whatever I had could be cured until then

days 31-54: losing my mind, had everything going for me great girlfriend, job, education etc.  down the toilet.  occasional hot/cold flashes 1 or 2 nightsweats, white tongue got worse (thrush),

day 54:  breakdown and go get oraquick blood drop:  NEGATIVE; could not believe it, still don't

days 54-80:  1 or 2 nightsweats, chills on 1 arm not the other, thrush getting better than coming back

days 80-90: only thrush, scared to test, my doctor gives me not only CBC but full immunity, liver fcn, everything you can test for that's not STD; all very normal except high cholesterol (234) which runs in my family, he thinks i am fine

day 100:  breakdown again, go to HIV clinic; oraquick advance oral swab:  NEGATIVE????? no freaking way

day 101:  examined by my GP, full body x-ray, everything, dx's a little thrush in the back of my throat, doesn't prescribe anything, told me i need to quit smoking 2 packs a day and drinking, 1 swollen node in neck

day 101 to 131(today):  fluctuating thrush (all over tongue today), and severe tinnitus (ringing in ears) that is becoming bothersome, I did have ear surgery on May 17th, 05' (approx 1 month before exposure)

So Doctor; My question is:  can I rest with my test results? basically the only symptom i didn't have is swollen nodes and rash on my trunk. i mean is there anything else that can cause this array of symptoms, Im no worry well and I actually had a real exposure so be honest with me.  I'd like to rely on this latest result.

[H. Hunter Handsfield, M.D.]

All your symptoms mean NOTHING with respect to HIV; in fact, I didn't try to read your message carefully enough to learn all your symptoms.  SYMPTOMS BY THEMSELVES ARE NEVER A RELIABLE INDICATOR OF HIV INFECTION; NEVER.  The only important information you provide is 1) your doctincluding one more than 3 months after exposure.  You do not have HIV, period.

I don't know what you mean by "thrush", which is a yeast infection of the mouth and throat.  You cannot diagnose it yourself.  A white-coated tongue is not the same thing.

On top of all this, your exposure was not particularly high risk.  Few female prostititutes in Las Vegas (or elsewhere in the US) have HIV; and even if she was infected, your chance of catching it was somewhere around 1 in 1000.

Please do not follow up with any "yes, but" questions.  You do not have HIV.  Follow up with your own doctors; I cannot help further.  (And I endorse your doctor's advice to stop smoking.  It is a greater risk to your health than unprotected sex with Las Vegas hookers.)

Good luck--  HHH, MD

[binky2005]

You said: she "didn't look like an IV drug user, but I remember her saying she was from San Francisco."

I don't understand. Are there a lot of IV drug users in San Francisco? I know a lot of people from San Francisco, and none of them are IV drug users.

Anyway, you don't have HIV.  I would highly recommend a book  entitled "Phantom Illness" by Carla Cantor. I really think you should read it. I think it will help calm you down. Seriously.

[Imdumb]

With a negative HIV test past 3 months you have ZERO chance of HIV and with your negative STD tests none of this is or ever was an STD. You might want to take your doctors advice and stop smoking and cut back on the adult beverages.

[regretfulSOB]

I meant that San Francisco has a probably high incidence of HIV.  The weird thing was, after it was over, she acted strange and evasive and jumped in the shower saying she had to meet people for dinner and then I left.

[probneurotic]

Relax, you dont have HIV.  

Your thrush can most likely be explained by the battery of high dose antiobiotics you have been taking over the last few months.  Candida (thrush) is supressed by the normal flora in your mouth, and when you kill it with thermonuclear antibiotics like that, it goes crazy, but nothing to worry about, and can be cleared by some antifungals, but may take some time.

The rest of the symptoms sound a lot like anxiety.  The percieved risk of losing your life is making you really lose your mind, but this happens A LOT.  In fact, all that stress can have an actual physiological affect on the body like you describe (increased anxiety = increases fight or flight response by the sympathetic nervous system = GI problems, sweating, and lots of other things...).  

I had a similar experiance, except involving Herpes.  After two negative antibody tests and much counseling, I decided to start dealing with my psychological/guilt issues instead of focusing on a disease that I didnt have, and it really helped.  So I definitely feel you...  

Hope you feel better, and you aren't alone!

[regretfulSOB]

Doc,

It was and is indeed thrush, my doctor called it out immediately upon seeing it, said he never saw it in a 25 year old healthy male but said it could be do to antibiotics/smoking, said it would probably go away on its own.
  Also, she wasn't a prostitute, just some 35 year old woman I met at the pool.  I just am freaked out after reading bad things about the rapid tests.  Thanks for your response Doc, its just that I never had any symptoms of anything after sex or NSU or thrush, or a HPV outbreak that coincided with all of it and I'm still very stressed about it.  Just need some words of encouragement I guess.

[regretfulSOB]

I went to the ER with the nightsweats, told them I thought I had ARS and they said it's possible.  They gave ambien and xanax, and I still had nightsweats on these relaxants.

[monkeyflower]

I don't think your doctor's right about never seeing thrush in a healthy 25 year old male. It happens often enough, especially after taking a lot of antibiotics. Listen to Dr. Handsfield. Your test was fine, and YOU are fine. I think it's more important to quit smoking and get your cholesterol down - those things are going to kill you.

You lost your gf, your job and your education over this? I think seeing a therapist is definitely in order; this anxiety is taking over and ruining your life. You have nothing to worry about physically - now I think it's probably time to deal with the emotional issues underlying these fears.

[gotherpeslifeisover]

Anxiety is a *****..a big, greasy, nasty *****! I know what dude is going through. My days lately have consisted of sleepin til 3 P.M., getting online til about 10, with a cigarette about every 30 minutes, and anxiously watching the clock waiting for 11 PM so I can go outside and sit in my car and drink lots of beer without anyone knowing. I avoid contact with people..including family and close friends. This ain't livin' Holmes!

[H. Hunter Handsfield, M.D.]

(Are SOBWW and regretfulSOB the same person?  It would be helpful to stick with one username.)

Even if you have real yeast infection of the mouth, you can be certain you don't have HIV.  Not only is monkeyflower right, but I had an oral yeast infection myself ~20 years ago.  I won't tell you how I got it, but I do not and did not have HIV or any risks for it.

HHH, MD

[regretfulSOB]

sorry doc, i'm not sure how that got changed, and yes, my thrush is really diagnosed, I had a white tongue when I was ill 2 weeks after exposure, then after the antibiotics it became red and burned, then came the cottage cheese all over it.  there were nights that i could not sleep because it burned so severely, never had anything like it. Also, is tinnitus a symptom of syphilis??  I did not test for that except for 2 weeks post exposure.  Just to let you know, I never even knew what ARS was nor feared HIV until I had a weeks worth of nightsweats which convinced me, that's why I'm so worried because I had no idea about any of this until after 2-3 weeks worth of symptoms.    forgot to mention that I also lost 10 lbs during this ordeal.  I'm so afraid.

[regretfulSOB]

I just don't understand, at first I was worried about Herpes and the prodromal symptoms or whatever, I can't believe that's what I was worried about.

[H. Hunter Handsfield, M.D.]

To quote from my original response:  "Follow up with your own doctors; I cannot help further."  You have nothing that sounds like an indication of a serious health threat. This is my last response on this thread.

HHH, MD

[NorwayGuy]

Dear Regretful,

I also ended up freaking out after having unexplained thrush some years ago after a low risk exposure. While my antibody stayed negative along with a very good DNA-PCR, I CONTINUED freaking out and had a nervous breakdown due to HIV anxiety. One contributing factor here was that an MD did find a HIV-like imbalance between my cd4s and cd8s (lymphocytes). While he reassured me that this was not HIV, I ended up on strong anti-depressants due to HIV-anxiety. After having been examined by one of the best immunologists in Northern Europe, they found out that I have hypothyreosis which is now being successfully treated (this may have contributed to my symptoms, but was for sure not HIV!). However, what you could learn from my story is the following:

1) Thrush (even unexplained, you have a fully adequate explanation from your typically trush-creating antibiotics) is not the same as HIV.

2) Negative HIV-serologies - in reality after 4-6 weeks and for sure after 3 months - are extremely strong predictors that you do not have HIV. The cases that fail to seroconvert are so rare that you wouldn't believe it. The extreme sensitivity of tests is actually one of the brightest spots in our work to prevent HIV disease in the community.

3) You could easily end up like me - pushing yourself over the edge and ending up with depression and anxiety - and the road back from there may be cumbersome and have very negative effects on your life. There are strong arguments in favour of councelling and other kinds of preventive treatment in your situation.

Stay calm,

regards from Norway guy

[regretfulSOB]

How do you feel about rapid tests.  I took the oraquick advance oral swab at day 100, made the clinician show me the control line and everything.  The only thing that worries me is that it took like 45 minutes until they called me back in.

[Imdumb]

Oraquick at 3 months is 100 percent assurance that you are not affected. The 45 minute result is of no consequence. When I did oraquick the person doing it said the used to have a 40 minute policy before giving results. She said this was only for the clinician to prepare themslevs if the result was positive. They changed that policy and started giving results immeadiately. Sounds like you place has the 40 minute policy. Rest easy that you do not have HIV.

[regretfulSOB]

You don't think it's possible that he switched mine with someone elses do you, I mean I had a number and everything and he seemed pretty confident that I was negative and that was my number.  I mean usually they don't show the test at all to you, I just am confused why he said "sorry it took so long I wanted to wait to make sure".  I guess im reading too much into it.

[Imdumb]

Oh man - don't start playing those mind games with yourslef. It is funny what we will conjure up. When I got my chlamydia test results over the phone I remember worrying for a couple of days that the lady pulled up the wrong number in the computer. Maybe she made a typo. Or maybe they mixed up when they entered the result in the computer. Then I thought maybe another patient switched his urine sample with mine. See where I am going? You are negative and should get HIV out of your mind.