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help me dr bruce
Nov 11, 2002

hi doc, first of all wud like to convey thanx for the great help ur doing for human community here. and sorry for my longets letter u might have ever seen.but i need help.i been posting to all the doctors here.but nobody bothered to answer my geniuine concenrns.please help me by answering my questions.

i am 27 years old male from london.i need ur help in my unusualcase(?).i am basically from india setteled in london.the thing is i had spent my whole last year in india for my buisiness.there i had almost 10 episodes of unprotected sex with a lady of promiscuous past.i didn't have much knowledge about hiv then.after my last episode in november 2001 (after two weeks) i had long spells of dizziness and nosia.after that i am back to london.i was tested negative on different tests(6,7,8,9 eliza's,6 month p-24,9 month rna viral load tests).i was extremely worried coz of my persistant symptoms.i have noticed rash,and dizziness in mrach and they still persists. and one more unusual symptom is swellings of limbs since 6 i felt that there may be a possiblity of kaposi's sarcoma i consulted many doctors includng leading lymphodema specialist and dermotologist dr.mortimer,but he felt that its not kaposi's sracoma.he says that kaposi's leisions doesnt come and go.but as i know my body well i could notice red unpainful protursions coming and going off and lumps in my head which are also coming and going off and they are also red and i am still experiencing joint pains and tiredness as well as fatigue.i been to lots of doctors including my g.p and leading hiv doctor in europe dr.simon barton at nine months.and he tested me for hiv at nine moths on elisa and hiv rna test and he felt that its not hiv.and he took a chest x ray for kaposi's sarcoma by claiming dat if i have it it shows in chest x- ray.and it didn't show anything.and he claims that its not possible to get kaposi's sarcoma by a hiv negative individual unless he is immuno suppressive and he took cd4 ratio and it was normal.none of my doctors suggested a biopsy of my skin leisons.and one more point i forgot to tell u is i had one leison on my penis in march with whitish center and the genito urinary medicine doctor in gum clinic removed that whitis substance at center and it went off.i am ver much concerned about my health as i am having lots of pressure to marry a gal from my family and i am scared coz of my health. i wann ask few questions if u dont mind. can u please answer these questions to healp me to gr8 extent.

1) as i was tested negative for hiv-1 and hiv-2 at 6,7,8,9 months after my last exposure what are the chances of me catching it?( i have read some where that its possible to seroconevrt later up to two years for some people-even though dr.barton feels that it happens only in people with repeated exposures) i have to be tested for hiv-o and n strains given my symptoms?(i dont know whether hiv1,2 tests conducted in london test for that) i read some where that in india hiv-c is prevalent do i need to get tested for that? kapos's sarcoma leisons come and go my lymphodema doctor felt that its not lymphodema and its due to stress,have u seen any cases of swelling of limbs(doctor can see only enlarged muscle there and hose swellings are itchy when hot water poured on them) due to stress? 5.does kaposi's sarcoma leisons come and go in two days and they turn normal when i press on them given my swellings(do edema occur only in advanced stages?)can they cvome and go given their first apperance since six months.

please can u clarify these things that wud be a great hep to me.thanx for ur patience reading this question.please help me.i wud be very greatful to u.thanx for ur suggestions

regards rahul

Response from Dr. Dezube

That's quite a saga, and I'm not sure that I'll address all your questions. I'll comment on two-- First, you are HIV negative and I would leave it at that. You do not have to get retested unless of course you have new exposures. Second, KS would indeed be unusual, but not impossible, in your setting. If your lesions return, it would be reasonable to biopsy them to see what they are. In that way, you would be able to put your concerns about KS to rest.

anal warts; what follow up do you need if they have been removed?
Chemotherapy & CD4 rise

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