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Exposure and problems can't get any answer on other forum... Need Help
May 12, 2002

Hi Doctor! I have a question that I hope you can help me with. I am a 36 year old gay man. In the past I have been with a few (4) other men and about 3 yrs ago got pretty sick and my WBC dropped to 3.7 and I developed swollen lymph nodes in my neck and groin after being with a man who I have found out recently is positive. The last couple years I have been bothered by these persistently swollen lymph nodes, fungal infections in my mouth, and constantly cracking on the corners of my lips that my doctor told me was a fungal infection also and fungal infections on my feet that keep occuring, incredibly dry skin that itches all the time and dermatitis on my face and scalp. At first I wasn't really concerned about HIV since I was safe but I have been getting worried since this doesn't seem to be going away. My doctor sent me to an infectious disease specialist who did a biposy of the lymphnodes in my groin. It came back reactive. She also did a bunch of tests for STD's and all came back negative. They were HIV, CMV, Hep B & C and Syphillis...She was also concerned about HIV and did a viral load test which came back undetectable. I never had any of these problems before and it took 9 months for my WBC to come back up to a normal range. All these tests were done about 18 months ago which would of been about 14 months after I was last with someone. I was always safe when I was with other people. I didn't do anything without a condom. Actually, the last person I was with was the guy who caused these problems. Should I get tested again? I only saw the Infectious disease doctor once for the tests and once for the results. But is one test for HIV enough with the viral load? Is their anything else I should do? I was prompted to write because I have been experiencing a really bad cough for the last 8 months with alot of bad sinus problems that I never had before. When I looked it up on the internet with all my other symptoms it keeps coming up with HIV as a cause and since I found out he was positive I am concerned. Thank-you and I hope this wasn't too long.

Response from Dr. Frascino

Hi,

An HIV antibody test and PCR viral load 14 months after an exposure is quite conclusive. It's not HIV. Also, since you practiced safe sex, your risk is incredibly low. Should you be tested again? I don't think it's necessary, as it will undoubtedly be negative. What you should do is have further evaluation of your medical problems. Certainly, something is going on. You may need a dermatologist to help with the dry, itchy skin, fungal infections, and angular cheleitis (cracking at the corners of the mouth). The cough should also be evaluated. It might be secondary to your sinus inflammation or an unrelated chest problem. The enlarged lymph nodes should also be monitored for progression or regression. And your transient low white blood cell count still hasn't been accounted for. See the infectious disease doctor again and have another evaluation. S/he may send you to a dermatologist, ENT specialist (for sinus problems), or an immunologist, if they feel your immune system isn't functioning quite right. Certainly, if any of the doctors want you to have another HIV test, go ahead and take it, but in general, since you had essentially a little to no risk exposure (condom), and you had a negative antibody and viral load test at 14 months, HIV has essentially been ruled out. It's important to note that there are lots of other diseases you could have; and luckily, they almost all have cures or at least much better treatments than we have for HIV.

Good luck.

Dr. Bob


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