HIV-SERONEGATIVE (PLEASE READ ENTIRE POST)

[bill611]

I had a high risk exposure about 3.5 months ago. It was unprotected insertive anal and unprotected insertive oral with another man whose HIV status is unknown. I am concerned about my risk due to symptoms I have been experiencing. The next day after my exposure, I noticed a red mark on my upper lip, this mark disappeared within a few days. However, about a week and a half later I began to experience several small aphthous oral ulcers inside my lower lip, and a white tongue with raised papillae. It was later confirmed as thrush. I began to experienced low grade fever,, insomnia, malaise, couldn’t eat, lost 5-10lb. These flu like symptoms persisted for about of a week. I know generally that results are supposed to trump symptoms, but I am afraid that I might be a seronegative patient, as I have had Vitiligo since I was young and I know it is classified as an autoimmune disease. Could hereditary Vitiligo delay or prevent my seroconversion, or affect my test results? Negative EIA at 14 days, Negative PCR DNA at 23 days, Negative EIA and 8 panel std test at 70 days,Negative EIA at 86 days. The testing was ordered online and performed at Labcorp and Quest Diagnostics. Also, had a Negative Oraquick oral swab at 106 days. The ulcers cleared up, but the thrush remains. I have taken prescription antifungals with no real results.  Also, I my gums are now white/gray. This could be the beginning of opportunistic oral diseases, such as periodontal/gingivitis. Around day 100 I had a very pronounced rash develop on my trunk and hips resembling herpes zoster. This rash was itchy but was not painful. This rash has faded somewhat, but is still present to some extent. I'd like to know if I can consider my test results definitive and conclusive despite my scary and persisting symptoms, and possible immunosuppression? I am a 22 year old with no other known health issues, and tested negative for diabetes. Could I be an infected seronegative case? Should I see an infectious disease expert?

[Edward W Hook, MD]

You should not continue to self-medicate if your possible fungal infection is not responding to therapy but should seek the input of a trained clinician.  EWH

[bill611]

Does anyone else have any thoughts on my troubling situation? I have tried 4 anti-fungal treatments with minimal results

[Edward W Hook, MD]

No change in my assessment or advice.  EWH

[bill611]

This has been a trying time, and I thoroughly appreciate your answer. The anal sex wasn't completely unprotected, I had a condom, but we used hand lotion as lubrication. I have read conflicting information regarding how oil based lubricants can degrade latex and pass HIV. If the condom didn't break, is HIV still a risk?

[Edward W Hook, MD]

Welcome to the Forum.  You did not get HIV from your exposure of concern.  The combination of your multiple negative antibody tests AND your negative PCR combine to categorically rule out the possibility that you could HIV infected but seronegative.  There is no reason for continuing concern about HIV or additional testing.  Your hereditary vitiligo does not change this. There is similarly no need to see an ID specialist.

If this reassurance does not relieve you concerns, you may wish to seek evaluation for other possible illnesses but continuing concern about HIV is not a good use of your time,

I hope my comments are reassuring.  EWH