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Avatar universal

Hiv or not doc

Hello Dr HHH

Ill keep this as simple as possible

Im a white male living in South Africa

Had a negative elisa test at 8.4 weeks after unprotected vaginal and oral sex but we are more at risk in this country!!!  Although its more prevalent amongst black africans rather than white africans.

I developed what looked like a median rhomboid glossitis on the dorsum of my tongue 5 weeks after the incident.  It sort of cleared up with anti fungal medication. No other symptoms apart from a sharp pain through my right side of my neck which might have been glands. Still get that pain now and again 3 months later.

Bad part is that my tongue has been furry or a little hairy on top(dorsum) for about 3 months now. It gets very white and creamy from the fur holding up debris and bacteria


1.  is this furry tongue which still remains slightly red but not sore indicative of a virus in the body.  

2.  Wouldnt problems with the tongue come much later in hiv than 3 months

3.  I know you say 8 week hiv test is conclusive but thats to americans where hiv is uncommon.  Because Im in S A should I go for another test.

4.  Do my symptoms sound common for Hiv or am I being an idiot.

5.  Anything you can comment will help

19 Responses
239123 tn?1267651214
Question 3 first, because it is central to your other questions:  You are right.  The higher the risk of HIV exposure, the more important it is to be tested later rather than earlier.  Although your negative result 8 weeks after possible exposure is highly (probably almost 99%) reliable, because you are in a country where heterosexual transmission of HIV is very common, you should be tested again at 3 months.  (See other threads on "time to positive HIV test" for information about why the level of risk influences this.)

1 and 2) Having said that, the test result remains infinitely more reliable than symptoms as an indicator of HIV infection.  "Furry" (or coated) tongue has lots of potential causes in addition to HIV.  And yes, tongue abnormalities are much more likely with late than early HIV infection.  4) You aren't being an idiot by any means, but your symptoms do not suggest HIV.

5) Other comments?  First, your 8 week test result makes it extremely unlikely you acquired HIV during the exposure you describe--but get tested again in another month.  Second, for goodness' sake, what the heck are you doing having unprotected sex (assuming this was a non-monogamous context) in South Africa??!!  Don't do it again.

Best wishes.  Get (and stay) safe.   HHH, MD
Avatar universal
my mother is a dental hygenist and thats why i am answering your question. she has a book with pictures of different oral problems and hairy tongue was one of them so i found a website that talks about this that you can take a look at.http://www.emedicine.com/derm/topic639.htm
pay attention to section 3 Clinical, while it is seen in patients with HIV it is not a symptom of HIV. it is mostly seen in people who drink a lot of tea or coffee or use tobacco products. also can be in result to poor oral hygiene
Avatar universal
I guess down there you should make sure the tests are checking for HIV-1 and HIV-2, I would be surprised if they weren't.
Avatar universal
I wonder why it is so prevalent down there, and like you said with black Africans particularly. I don't see how the 1/1000 or 1/2000 average risk for heterosexual contact could apply in that region, it's not enough to sustain that kind of infection percentage. Either everyone is having sex when the viral load is really high or there are a lot of other std's being spread around causing the elevated transmission risk. And why the racial division?
Avatar universal
I have a question regarding the regional geography risks involved.  You recommended another test at 3 months due to the persons geographical location, however was this also due to the activity performed?  Lets say a person has protected vaginal sex or protected oral sex in Africa, would your testing recommendations differ if the person was say in North America?
239123 tn?1267651214
Search the threads and archives.  common in some parts of the world than others (i.e., in some populations than others), and the risks of vaginal intercourse higher, has been discussed.  (Try searching old threads for "HIV transmission risk".)  It's quite complex, but the expalanations include circumcision status of men, background STD rates, "dry sex" and other sex practices, average viral load, stage of the HIV epidemic (related to viral load), relative infrequency of antiretroviral therapy, and others.

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