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infected couple but too much confusion .
Apr 12, 2011

Doctor,

6 Months ago I had unprotected vaginal exposure with a HIV + female, two week later, I started to have: fever, rash, oral thrush, yeast infection,blurred vision and floaters, generalized painfull lymphadenopathy, and later I was diagnosed with peripheral neuropathy and the blood work shows infection compatible with HIV (low lymphocyte, low palettesetc ) my CD4 went from 920 at 1 month from exposure to 380 at 6 months, CD4/CD8 went from 1.15 at 1 months to 0.52 at 6 months, I tested negative at 3 months, then I was told that it was conclusive, I had unprotected sex with my wife, three weeks she started to have the same symptoms that I had, and now we had both generalized painful lymphadenopathy, and sever Peripheral neuropathy (Diagnosed by Neurologist), I tested negative 15 times up to 6 months after exposure with Elisa 4th generation, and one negative AMPLICOR 1.5, RNA- PCR viral load that looks for Group M only.

My wife tested several times negative up to 20 weeks after her exposure.

Is it an infection with a variant virus that is not detected by the tests we have done as the HIV+ female boy friend were from Africa?

Our GP said it may be an HIV virus with neurological tropic proprieties, as our neurological symptoms are getting worst, but he said that he cant see what should be done as the antibody tests still negative.

What tests should be done to resolve this case?

Thank you

Response from Dr. McGowan

I am sorry to hear that you and your wife are unwell.

The symptoms you have are fairly non-specific and could be caused by conditions other than HIV. You have a "mononucleosis" like illness. This couold be caused by viruses such as Epstein Barr (EBV), cytomegalovirus (CMV), toxoplasmosis in addition to HIV. These other causes should be explored. If the infetion was a non-M starin, the current screening tests will pick up group M non-B (which would be most likley from Africa) with no problem, and HIV-2 as well. Rarely, if a person came from Central Africa (Cameroon), they may have group O infection. 80% of these will be picked up by standard screening. Even people from these regions are more likely to be infected with group M than group O. You should have your CD tests followed up after the acute symptoms are over. If they remain abnormal and the above work-up is negative your doctor can discuss your case with the local health department to get access to further testing.

Joe



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