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An unusual problem
May 27, 2004

Dr. Pierone,

I have a case you might be interested in. I was given a presumptive HIV diagnosis by an HIV specialist many months ago, based on clincial exam and previous concurrent diagnoses. (URI, ear infection, pharangitis, trunk/facial rashes, extreme fatigue, folliculitis, swollen lymph nodes, oral lichen planus, malabsorption, aseptic meningitis, unintended weight loss).

The problem has been that my antibody tests have been negative--17 months post-exposure. Viral load tests were conducted 3, 6 and 12 months after these multiple infections. All undetectable.

I'm still dealing with post-meningitis lightheadedness, oral lesions, extreme fatigue, malabsoprtion, etc.

What do you think I should do? I was a health nut before all these infections and nobody has come up with a reason as to why I've been experiencing problems which according to the HIV specialist I'd seen, mimick acute HIV infection.

I'm really suffering now and have been for over a year. I really need your help.

Thanks

Response from Dr. Pierone

It is possible to make a presumptive diagnosis of HIV based on clinical symptoms which is subsequently disproved on the basis of negative blood tests.

It sounds like you had a severe viral infection and now have a post viral fatigue syndrome. Most people with post viral symptoms eventually recover, but it may take a very long time. Mononucleosis (from Epstein-Barr or CMV infection) is a good example of a prolonged viral infection in susceptible persons. The best advice that I can give is to hang in there, continue healthy life habits, and eventually things will return to normal. Best of luck to you!



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