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Skin Conditions and Early HIV Infection
Hello Dr's,
Hope you all were able to attend the AIDS 2012 Conference in my hometown. I have been following this site for some time after an exposure and am aware of the hierarchy of tests, risk factor, and symptoms (being the least reliable) however I would greatly appreciate your input as neither my GP or Dermatologist seem to be very knowledgeable about HIV. Approximately 4 months ago I gave/received unprotected oral sex from a partner of unknown status (I am male) who had been biting my lower lip quite vigorously beforehand (low risk). I had antibody testing (ICMA) through 87 days all negative. What frightens me is the following month my current gf fell ill with severe gastrointestinal (diarrhea/vomit for several days) approximately two weeks after unprotected sex with me. In the time between my exposure and now I have experienced diarrhea, lack of appetite, weight loss, tinea versicolor, angular cheilitis, cystic acne, and what worries me most is now I have clustering folliculitis in my groin (I have never shaved down there) and non-clustering/sporadic folliculitis in my forearms and back of my hands (never had before). The folliculitis began after my 87 day test, the clindamycin given to me by my dermatologist is not improving the groin area. I recall Dr Hook saying a specific form of folliculitis may occur in Early HIV infection - 1) Is the presentation of that folliculitis similar to what I described? 2) Would there be any added benefit to another antibody test? 3) Are any of mine or my GF's symptoms concerning? 4) Is continuing unprotected sex with my girlfriend safe at this point? I have been screened for all other STDs with a negative result.
I can live with putting myself at risk, it's just my GF I worry about at this point, lesson learned.
Thanks for all you guys do.
JW
Hope you all were able to attend the AIDS 2012 Conference in my hometown. I have been following this site for some time after an exposure and am aware of the hierarchy of tests, risk factor, and symptoms (being the least reliable) however I would greatly appreciate your input as neither my GP or Dermatologist seem to be very knowledgeable about HIV. Approximately 4 months ago I gave/received unprotected oral sex from a partner of unknown status (I am male) who had been biting my lower lip quite vigorously beforehand (low risk). I had antibody testing (ICMA) through 87 days all negative. What frightens me is the following month my current gf fell ill with severe gastrointestinal (diarrhea/vomit for several days) approximately two weeks after unprotected sex with me. In the time between my exposure and now I have experienced diarrhea, lack of appetite, weight loss, tinea versicolor, angular cheilitis, cystic acne, and what worries me most is now I have clustering folliculitis in my groin (I have never shaved down there) and non-clustering/sporadic folliculitis in my forearms and back of my hands (never had before). The folliculitis began after my 87 day test, the clindamycin given to me by my dermatologist is not improving the groin area. I recall Dr Hook saying a specific form of folliculitis may occur in Early HIV infection - 1) Is the presentation of that folliculitis similar to what I described? 2) Would there be any added benefit to another antibody test? 3) Are any of mine or my GF's symptoms concerning? 4) Is continuing unprotected sex with my girlfriend safe at this point? I have been screened for all other STDs with a negative result.
I can live with putting myself at risk, it's just my GF I worry about at this point, lesson learned.
Thanks for all you guys do.
JW
MEDICAL PROFESSIONAL
Welcome to the forum.
Since you are "aware of the hierarchy of tests, risk factor, and symptoms (being the least reliable)", you probably have predicted my replies. You even posted accurate advice about this to other users in your June 21 comment in your previous community forum. Repeating some things you already know, there are NO skin conditions that, by themselves, are highly suggestive that someone has HIV -- including all the ones you mention. Your negative antibody test ~3 months after your last possible exposure proves you don't have HIV. To your specific questions:
1) Folliculitis doesn't occur with especially high frequency in HIV infected persons and is never a signfiicant indication that someone has HIV.
2) No further testing is necessary. You can rely on your negative result.
3) Neither your nor your partner's symptoms can possibly be due to HIV, given the test result -- and they don't sound typical for HIV anyway.
4) From an HIV standpoint, you can safely continue unprotected sex with your partner.
Regards-- HHH, MD
Since you are "aware of the hierarchy of tests, risk factor, and symptoms (being the least reliable)", you probably have predicted my replies. You even posted accurate advice about this to other users in your June 21 comment in your previous community forum. Repeating some things you already know, there are NO skin conditions that, by themselves, are highly suggestive that someone has HIV -- including all the ones you mention. Your negative antibody test ~3 months after your last possible exposure proves you don't have HIV. To your specific questions:
1) Folliculitis doesn't occur with especially high frequency in HIV infected persons and is never a signfiicant indication that someone has HIV.
2) No further testing is necessary. You can rely on your negative result.
3) Neither your nor your partner's symptoms can possibly be due to HIV, given the test result -- and they don't sound typical for HIV anyway.
4) From an HIV standpoint, you can safely continue unprotected sex with your partner.
Regards-- HHH, MD
MEDICAL PROFESSIONAL
It was already 100% certain you did not have HIV, even without this addtional test. Note my initial reply to question no. 2.
Folliculitis that persists is a very common dermatological problem. Almost nobody with this problem has HIV. Continue to work with your dermatologist about the skin problem, but disregard HIV. You don't have it.
Folliculitis that persists is a very common dermatological problem. Almost nobody with this problem has HIV. Continue to work with your dermatologist about the skin problem, but disregard HIV. You don't have it.
Just received a negative 16 week ICMA test from labcorp - does that nail it down without a doubt? The folliculitis still persists (6 weeks now) - I explored the molluscum option with my dermatologist who said the presentation doesn't match - I would not care if I had one or two pustules but the aggressive, clustering nature seems worrisome. Sorry to revive a dead post - I guess it's psychiatrist time for me...
Thank you Doctor. You guys rock.
MEDICAL PROFESSIONAL
Follow-up questions per se are never a problem -- only follow-up questions that ignore or seem to entirely miss the main points of previous replies are not especially welcome.
On this and the STD forum we avoid speculating on non-STD, non-HIV explanations for symptoms-- and as discussed above, your test results make it clear that the problem isn't HIV related. But folliculitis is a straightforward, bread-and-butter issue for any dermatologist; if that was the dermatologist's diagnosis, most likely it is reliable. Having said that, bumps in the groin and pubic area makes me think of molluscum contagiosum, a minor viral infection that in adults usually is an STD. You might look for it on the web -- lots of photos are available. But regardless of that, if it persists or you remain concerned about it, I recommend you return to the dermatologist. In any case, I remain confident you don't have HIV.
On this and the STD forum we avoid speculating on non-STD, non-HIV explanations for symptoms-- and as discussed above, your test results make it clear that the problem isn't HIV related. But folliculitis is a straightforward, bread-and-butter issue for any dermatologist; if that was the dermatologist's diagnosis, most likely it is reliable. Having said that, bumps in the groin and pubic area makes me think of molluscum contagiosum, a minor viral infection that in adults usually is an STD. You might look for it on the web -- lots of photos are available. But regardless of that, if it persists or you remain concerned about it, I recommend you return to the dermatologist. In any case, I remain confident you don't have HIV.
Thank you for your prompt response. I know you are not a big fan of follow ups so I assure you - only one. The folliculitis in my groin has spread and now consists of approximately 25 bumps on either side of my groin and a couple scattered in my pubic hair. Not knowing the cause is stressing me out, I have not had any lifestyle changes and it is not responding to the clindamycin. Is it possible this is something other than folliculitis? It does itch - I know you are wary of defining skin conditions as HIV related because of the hundreds of readers who review your words with a fine tooth comb, but it would really help me gain closure knowing if this is characteristic of the folliculitis sometimes seen in early HIV infection which Dr Hook mentioned in the past. I look forward to your response - there will be no more follow ups.
Thank you.
Thank you.
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