Confused About What to Think

[goinginsane007]

Dr. HHH,

I had unprotected vaginal sex with a woman 10 weeks ago.  About 1.5 weeks after the encounter, I became extremely fatigued.  Around the same time, I felt nauseous and started getting generalized itching w/o any apparent rash.  Two and a half weeks after the encounter, my submandibular glands became a bit swollen (PCP not concerned), the diarrhea began, and I started to have night sweats (not drenching).  At the same time, I also lost my appetite for a few days and dropped about 10 lbs.  Seventeen days after the encounter, my PCP did an HIV antibody test and a p24 antigen test (separate tests).  Both came back negative.  About three weeks after the encounter, I started to get a lot of pain and weakness in my legs.  My lower back started to ache and I got a lot of abdominal pain shortly thereafter.  

After obtaining negative mono, lupus, rheumatoid arthritis, strep throat, STD tests, etc., my PCP sent me to an infectious disease specialist, gastroenterologist, and oncologist/hematologist.  They also ran various blood tests and did both a CAT scan and ultrasound of my abdomen and pelvis.  Everything came back negative/normal.  The only thing that was abnormal since the beginning was my WBC count was around 11.8.  The infectious disease specialist wasn't concerned, because I hadn't been running any apparent fevers.  After the oncologist ruled out cancer, she mentioned HIV several times.  I really began to get worried again.  

So, where am I now?  Nobody has been able to diagnose me at this time.  My WBC count has dropped to 9.8.  My stools are still loose with bouts of diarrhea.  I still have pain and weakness in my legs, night sweats (still not drenching), and fatigue.  The woman that I was with had a negative HIV antibody test about 4 weeks after our encounter.  But, I have caught her in several lies about her sexual background.  So, I'm not sure if she could have tested during her window period or not.  

I am extremely concerned about the timing of the symptoms.  I have never felt like this before, and it seems all too ironic that it all started about a week or two after an unprotected sexual encounter.  

My most recent HIV antibody test at 9.5 weeks was negative.  It was a Home Access test.  

My first question is regarding the p24 antigen test.  I've read that the test is only reliable withing 3 weeks of a potential HIV exposure.  But, I've also read that the test is only reliable about a week before antibodies are detectable.  Could you please shed some light on this test for me?  

My second question is do submandibular glands typically swell during ARS?  The doctors have not noticed any other swollen lymph nodes.  My armpits were tender and felt swollen, but my PCP said that he didn't feel any swollen glands.  

Thirdly, do you think that I should be concerned about HIV?  I'm extremely scared and am looking for some reassurance.  

Thank you!

[o_g]

Check this out. Hopefully, it helps:

http://www.mass.gov/Eeohhs2/docs/dph/aids/guide_counsel_test.pdf

Link found by: bleeding badly

Take care

[goinginsane007]

Thank you for taking the time to respond to my questions.  However, my anxiety level has recently skyrocketed again.  You stated that my symptoms were classical anxiety/depression symptoms.  Well, I was recently diagnosed with lumbar radiculopathy.  So, it's not anxiety that's causing my leg pain and weakness.  A recent MRI showed that nothing structurally was pressing against any of my nerves.  That basically means that my radiculopathy was brought on by some type of infection.  I have read that radiculopathy is a symptom of PHI.  I did another Home Access test at 88 days, which was negative.  

Now, I'm beginning to question the reliability of the Home Access tests.  I'm also starting to wonder if HIV-2 is a definite possibility.  I had my PCP order HIV-1 and HIV-2 antibody tests.  In addition, I had him order Hep C and HIV-1 PCR tests.  

I'm literally going insane.  Any of your kind words of reassurance would be appreciated.  

Wishing you a happy New Year!

[H. Hunter Handsfield, M.D.]

No online provider can add anything useful after someone has had the evaluation you have had by your PCP and an ID specialist.  The latter undoubtedly knows just as much about HIV as I do.  You cannot have ARS, period; the negative HIV antibody test at 9+ weeks is absolutely reliable and proves that HIV does not explain your symptoms.  Your symptoms are classical for depression or anxiety.  If your docs haven't raised that possibility, you should ask them about it yourself.

Sorrry I cannot be more helpful.  It sounds like you are getting excellent care.  Follow up with your PCP and/or the ID specialist, accept their opinions and follow their advice.  But put HIV out of your mind and move on.

Good luck--   HHH, MD