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Avatar universal

Still very worried!

Dear Doctor,
I am am 40 year old male. I have seen on a few occasions, an Asian massage parlor. During the visits(different girls)most recent sept 30th, they have massage me and also fingered(inserted) me for a few minutes w/o barrier and w/lotion. I have never seen any cuts or nicks on their hands, maybe they could have bled in me with their digits and aquired HIV. Also, early Sept. I had received unprotected oral sex from an escort. Since oct 20th, I have had a strange smell that I believe is coming from my throat. I have now had a sore throat for a little over 3 months. I have had ent visit in which he said he didn't see anything. I have been to GI guy/. I have had ct of sinuses and chest xray which were WNL.  I have been treated with diflucan with minimal results. I also have a vast increase of little red spots on skin that came on before diflucan tx. I believe I have a whitish tongue with a crack in the middle. Also little white patches at angles of mouth. I have lost 15 lbs over 3 months now. Most recently I have had a pins/needles feeling in my left foot, which is worse in the morning. My left side of face is also tingly. I had MRI last week. Unremarkable except for notation of slight enhancement of post ganglionic left 7th nerve. Now as far as my testing. I have tested(from 9/30/09) numerous ways. By HIV 1/O/2 by ICMA techniquie at 1,6,11,13 weeks. By EIA technique at 3,14,17 weeks by bio-rad hiv1/2 gs plus OEIA. That test also checks for group O.  PCR-DNA at 6 weeks. And at 16,17 weeks by oraquick advance fingerprick tests. ALL tests were NEG. Also tested for other STD which was negative. Long and short, even with these wierd symptoms can I take faith in these tests? So most recent test 120 days by eia.  I did by the way get a cd4/cd8 test at six weeks. Cd4 was 697(49.8%) and cd8 337(24.1%). Ratio cd4/cd8 2.01.  All my other lab work is WNL. Are there any other subtypes/groups I should be looking for. Thank you in advance for your thoughts&time.      
14 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.  However, all I can do is repeat what you already were told on the HIV and STD community forums.  You said there that you were finally convinced you don't have HIV, but apparently not.  So here it is again:  You have been seriously overtested, way beyond what was reasonable or rational to assure you don't have HIV.  The results prove you do not.  Your symptoms don't matter, the CD4/CD8 results don't matter, and the level of HIV exposure risk doesn't matter; the HIV test results tell the story.  (In any case, you describe no symptoms or exposures that suggest high risk for HIV -- which is rarely if ever acquired by receiving oral sex.)  You need to accept the multiple reassurances you have had and move on, confident you don't have HIV.  Continue to work with your health care provider about the causes of any symptoms that continue to concern you.  And don't worry about your current or future sex partners; you cannot infect them with HIV because you don't have it.

Believe it.  Move on.  Good luck--

HHH, MD
Avatar universal
Thank you for your response. So even with all my wierd symptoms you would rule out HIV?  Are there any strains/subtypes/groups that the tests I have taken would not detect?  Also, a few other questions. 1)whatever the risk, do you feel confident in a 3 month tesT being conclusive, let alone my 4 month result. 2) how reliable do you think a pcr-DNA test is at six weeks?  3)Since I was with someone Asian, should I test for anything like HTLV?....and last....4)when was the last time you saw someone test negative like I have and go in to test poz?  What is your MAGIC # if weeks?  If I am
indeed negative I am going to take a great deal from
this ordeal and live to be a better person. I appreciate your time for responding. Thank you.    
239123 tn?1267651214
MEDICAL PROFESSIONAL
As long an enough time has passed for reliable testing, symptoms NEVER outweigh blood test results in judging whether or not someone has HIV.  Every symptom you describe is far more common in many conditions other than HIV.  And you had a zero risk exposure, for goodness' sake!  To the additional questions:

1) Yes, 100% confident.
2) Highly reliable.
3) No, but I'm not an expert in HTLV which has nothing to do with HIV/AIDS and thus is off topic for this forum.  You can ask your own doctor(s) about it, but you didn't have the sort of sexual exposure that was likely to infect you with HIV, HTLV, or anything else.  Oral sex is safe sex with respect to such viruses.
4) In 30+ years, I have never had a patient whose HIV antibody test was negative at 6 weeks or later who turned out to have HIV, nor have I heard such a story from any of my colleagues.  There is no single "magic" no. of weeks, but 6-8 weeks usually is plenty and 12 weeks always is long enough for reliable results.

That will end this thread -- no continuing "yes but" or "what if" questions please.  You came here for reassurance that you don't have HIV.  I gave it.  Accept it and move on.  I won't have anything more to say.
Avatar universal
Thank you very much! If you are ever in the area we can toast with a beer or two. As a layman- with some medical training, that's why I'm so inquisitive, how can I myself contribute to community forums. I magine do my research, and give people REAL/ACCURATE INFO, PEER-REVIEWED. I plan on doing this. Thank you and good luck for you and all you do to help others.  Take care
239123 tn?1267651214
MEDICAL PROFESSIONAL
Despite my attempt to end this thread, I have had to delete a number of follow-up comments both from Hopefulhere and others.  If HFH wants to continue the discussion, he can take it to the HIV community forum.

Thanks.
Avatar universal
Dr. HHH, I apologize for asking but my doctor didn't know the answer. Can taking fluconazole affect(cause false negative HIV antibody) results at 19 weeks?  Yes or no is fine. Thank you. This will be all for this thread.
239123 tn?1267651214
MEDICAL PROFESSIONAL
Definitely not.  No medicines have any effect HIV test results, with the possible exception of potent chemotherapy or immune suppressive drugs.
Avatar universal
Thank you very much. I got my 19 week negative ELISA yesterday. As I said earlier Dr., I wouldn't continue to test if it were not for some peripheral neuropathy and throat(responding to diflucan) infection. Thank you again for your time.
Avatar universal
Sorry to discuss this again, but since my response to diflucan is working to a small degree, he wants me to test again for HIV at the six month post exposure. My most recent test is 133 day ELISA negative. I just wanted to know your thoughts against his. Also he is concerned with my low 97.1 body temp. Would that point you in another/same direction?  Thank you
Avatar universal
Sorry, but "he" is my doctor. Forgot to add that.
239123 tn?1267651214
MEDICAL PROFESSIONAL
I see no reason for further HIV testing, but I always advise people to follow their own doctors' advice.

That's all for this thread.
Avatar universal
Dr. Handsfield, may I ask you one other question about testing that I cannot find anywhere on other forums?  I would greatly appreciate. If not, I understand your position. I just cannot find the answer anywhere
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