Jun 1, 2001
This question addresses your frequent advice that one must do everything one can do to rule out infection.
Exposure: Early May 2001. Nonconsensual high risk exposure to blood or semen through open cuts.
Symptoms: Fifteen days after the event, experienced fever, severe pharyngitis, oral ulcers, numbness in cheek, one swollen lymph node on neck. Everything but the fever and pharyngitis resolved in a week. Fever continued off and on for four months. Almost weekly bouts of pharyngitis...some severe..have continued for over one year to this date. Also occasional low grade fever.
Testing: Never having heard of ARS, I did nothing for four months. Then with continuing severe symptoms, I went to a major hospital's Infectious Disease Unit. They tested for P-24 anitgen, ran Elisa HIV 1 and 2, ran T-cell sub-sets and HIV RNA PCR (Roche 1.0), plus all regular blood work and specific cultures for pathogens. All negative.
At eight months, I returned and they repeated all tests, plus an HIV DNA PCR. Again, all negative.
At ten months (continuing symptoms unabated) and after considerable research and concerned about non-B clades, I visited major clinical and research group. This time they ran bDNA (3.0), HIV RNA PCR (Roche 1.5) and HIV DNA PCR, plus general viral culture, T-cell sub-set and full blood work and chemisty. Again, all normal.
Last week at 13 months, they ran a final Elisa for HIV 1 & 2. As you might guess, normal.
Semi-severe pharyngitis continues off and on, sometimes with almost full loss of my voice in addition to the usual rawness and difficulty in swallowing.
Sorry about the lenght of the history, but here are the questions.
1. Have I done everything I can to rule out HIV infection?
2. If not and if it was warranted, what else could be done? A direct HIV viral culture? Something else? Or should I put this to bed forever and just ride out the symptoms?
3. A recent article says the bDNA 3.0 quantifies clades A-G and detects Group O. What happened to Group M, Clades H-L?
You're the best and I hope the answers to these questions, if they are answered, help not only me, but others.
| Response from Dr. Holodniy
I think you have to look for another diagnosis.
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