Early DILS possibility?

[bbb777]

The initial " risk" - was  a male encounter with a female csx (the call to the room variety, ie a few $100's). Protected vaginal to start (fairly brief) followed by protected oral and protected manual. Observed no condom failure. At about 10 weeks developed geographic tongue and subsequently noticed dry mouth and eyes.  Read about an HIV radical autoimmune response - DILS (diffuse interstitial bla bla bla) and anxiety increased.    Eventually, (12 weeks to the day from the "incident",  it so happened) sought medical attention (felt like experiencing cognitive difficulty (couldn't think/concentrate - thought there may be central nervous system problems).  Went to emergency room  They did generic blood work (nothing unusual) and also ordered some kind of HIV test and a Syph test -  HIV was nonractive and the Syph test was also nonreactive.  Don't know test type or result details. 

Understand 12 weeks to be a solid test. But on the other hand the dry mouth / dry eyes (lasting now several weeks) have very few standard medical explanations -Sjogrens, meds (I'm not on any), or DILS.  So there's confusion and concern; false negatives are rare, the "encounter" as remembered should be "no risk", etc.   But the non-HIV medical explanations for symptoms are also extremely unlikely - ie Sjogrens is maybe 2% or so of population and of that 90% are women. Can anxiety be doing this?  Have you seen these symptoms from anxiety in patients?  Could this be/if this were early DILS (10 weeks-ish) could that occur without HIV antibody response?  Nonreactive is nice but still concerned   Any ideas? 

[bbb777]

Thanks. That's encouraging. I know that a few days before the geo tongue my anxiety was at it's highest - I think because I was approaching the 12 week point which I thought of as the point when I could actually do reliable testing.  When I say my anxiety was high I mean it was off the chart, like I was going insane. I believe geo tongue has been associated with anxiety so that's a reasonable connection.  Perhaps the other things are stress related as well. I consider myself OCD. More O than C but I've been known to do things like multiple checks on the stove before leaving the house, etc...

[Edward W Hook, MD]

No, if anything a DILS type reaction would increase the onset of your antibody reactivity, not diminsh it.  Not a concern.  Please try not to worry, there is really no reason to.  EWH

[bbb777]

Thank you for the fast response. I erred in citing the Sjog incidence - it's 2 million so that's 1 in say 150 people but 90% are women so maybe 1 in 1500 men. The timing would also be quite a coincidence. But the math does still favor non- HIV.  Curiosity - Would a DILS response to HIV mess with antibodies?  My understanding is that it's an extreme autoimmne response involving  CD8 cells but I'm wondering how that might relate to or impact the normal immune responses. Thanks for your help and dedication.  

[Edward W Hook, MD]

Welcome to our Forum and thanks for your thoughtful question.  You need to believe your test results.  The symptoms you describe are non-specific and uncommon but not nearly as uncommon as HIV. As a heterosexual male your risk of HIV overall is less than 1 in 10,000 (as opposed to say Sjogrens which involves 2% (i.e. 1 in 50) of the population.  Furthermore, the  exposure you describe is very, very low risk as well.  Please remember, most CSWs do not have HIV and even if your partner did, your risk from a single episode of vaginal intercourse is only 1 infection per 1,000 sex acts.  With a condom the risk, again, if she was infected, goes to 1 in a million or less.

Bottom  line, the risk of the encounter you describe is essentially zero and your test result confirms this. there really is no need for further testing.  If your symptoms really trouble you , you should see a medical professional to sort this out but HIV should not be part of the worry.  On the other hand, sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turn leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  

I hope this comment is helpful to you.  EWH