All out of logic...

[iamnotalegendatall]

So I used to be a completely logical person. However, this is something I can’t shake. To the facts:

Exposure – "Semi-protected" vaginal sex, but with new scratches on penis (not sure if there was any blood – I doubt it) that may not have been covered.

“ARS” Symptoms at 2 weeks – Sore throat, ulcer on gum.

Ongoing symptoms –

*Skin patches that Derm could not diagnose. These come and go.

*GERD

*Odd bowel movements

*Frequent colds

*Geographic tongue (started at 15 months post incident)

*Oral thrush – First noticed at 1.5 months post exposure. On tongue only. Doctor wasn’t sure that it was, said it was more likely a combination of coated & hairy tongue. However, it also extends behind the big papillae at the back of the tongue in smaller spots as far down as I can see. This has continued for 1.5 years. There is no soreness,  redness or bleeding under the patches when cleaned. Hasn’t got better or worse in this time.
Doctor now thinks it IS thrush and has sent of a culture & my blood for more testing (CBC, Glucose, Liver function, Kidney function, Hep B/C & HIV).
I have not taken any antibiotics for since at least 4 months prior to this exposure (so two years or so now), and only Beconaze nasal spray for allergies.

But I have already tested with the following results:

4 weeks – DUO Negative
16 Weeks – AB with Ag Negative
52 weeks – DUO Negative
15 months – AB with Ag Negative

So questions: 1)Is there any reason to suspect HIV (my GP seems to think so)?
2) If it is thrush, would it normally last this long without treatment?
3) Do I need an alternative form of testing? SOOOO many people seem to get DNA PCR / RNA tests – are they needed in this situation?

I know I have tested well outside any window period, but it all seems too much of a coincidence. Can you help? I am 27 and shouldn’t be getting thrush!

[H. Hunter Handsfield, M.D.]

You are the only person in the world surprised by those results.  But congratulations.

This truly ends this thread.

[iamnotalegendatall]

Just to give you an update, seeing as some readers in a similar situation may be interested:

Latest HIV ELISA as ordered by GP was negative.
Swab for thrush was negative.
My Dentist, during regular check-up, also said he did not think it was thrush, but is referring me to an Oral Medicine hospital to put my mind at ease.

Thanks again.

[H. Hunter Handsfield, M.D.]

"I was completely healthy - post exposure suddenly all these symptoms arrive":  that says nothing about the cause, and is equally compatible with an emotional response to the exposure as with any other reason.

"when you read people saying 'nothing is 100%' it can be disconcerting":  I can't say with 100% certainty that I won't be killed in my sleep by a meteorite.  But I don't worry about it or take steps to prevent it.

That's all for this thread.  If you're inclined to more comment, I suggest you re-read the last paragraph of my response above.  But really, let it go.  There is no way you have HIV.

[iamnotalegendatall]

Many thanks for your reply, Doctor.

I suppose I am concerned as before this exposure, I was completely healthy - post exposure suddenly all these symptoms arrive. Plus when you read people saying "nothing is 100%" it can be disconcerting.

[pcrissues]

I have had a very similar situation - exposure 10 months ago and have actually tested 17 times (including 4 PCRs and a Western Blot) all of which were negative.  My doctor tells me that geogrpahic tongue (which I also have) can be caused by stress.

best of luck

[H. Hunter Handsfield, M.D.]

You were given accurate responses on the HIV community forum.  The tests prove you don't have HIV and that something else is the cause of your symptoms.  There is no point and no need for additional HIV testing.  Anyway, there are no other HIV tests left to do!

I don't understand why you are so focused on HIV. You don't describe a single symptom that even hints at HIV!  Even if you had real thrush (oral yeast infection, which I doubt), the vast majority of oral thrush is not due to HIV and it doesn't necessarily indicate an immune deficiency.  (I had it myself once.)  "Geographic" tongue is normal in many people.

So the direct answer to questions 1 and 3 is definitely no.  For question 2, my bet is that the test for thrush (probably a culture for yeasts and other fungi) will be negative, but even if positive it won't have anything to do with HIV.  If you and/or your doctor remain convinced your oral symptoms and appearance of your tongue are abnormal or suggest a potential health problem of importance, then an opinion from your dentist or an oral medicine expert might be useful.  (Oral medicine is a specialty of dentistry; such specialists can be found at schools of dentistry, or sometimes in dental practices in urban areas.)

Whatever is going on, you need to accept the fact that you don't have HIV.  If you cannot let that idea go, it suggests a possible need for professional mental health care.  It is not normal to remain so certain despite such powerful evidence of a health problem that cannot possibly be present.  I suggest it out of compassion, not criticism.

Regards--  HHH, MD