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May 27, 2004

Dear Dr horwath

I have spent many weeks combing the archives and cant find a case like mine.

It all started in august 2003 when me and my new girlfreind both went to get rapid HIV tests (i am a 26/m/ american been living in thailand for last 18 months). Hers was negative, but my strip came back with one solid line and a faded line. The doctor at the clinic said i should go to a hospital for more tests. So that night we went to a hospital in bangkok, we showed the doctor my results of the test and he said he didnt believe this test and i should have their abbot labs rapid antibody test, which i did, and it came back negative, i was saved! or so i thought.

A month later i started getting mild fevers and i got a pain in my ear, another month on and i get a blocked up nose and im coughing up this really sticky clear stuff, which i still cough up to this day.

Me and my girlfreind both had 3 more of the abbot labs antibody tests over the next 4 months, all negative. needless to say HIV had taken over my life and i was very worried, in febuary i was looking at HIV symtoms on the internet, i read the list and realised i had every one, except white tounge, phew what a relief i didnt have white tongue, i walked into the bathroom and looked into the mirror stuck my tounge out and to my horror the top of my tounge was covered in white furry texture it was part of my tounge and wouldnt wipe off (is this EBV?). I was in shock, we got married and went to bali for the weekend, i was so ill i thought i was going to die there, i lost 10% of my body wieght over the next 3 days with cold sweats and no sleep for 3 nights, my mind was shot and my wife had to look after me like i was a kid becuase i couldnt even work out 2+2. my lymph nodes swelled up under my arms, and there was a rash on them, all my limbs ached. I was convinced this was seroconversion, and i was going to die soon unless i got treatment,so i stormed (or rather staggered) into another hospital back in bangkok and claimed i was dieing of HIV. I got some antivirals. completed the presription but didnt get any more becuase they made my butt hurt.

Anyway this was march now, i had started suffering oppurtunist infections allready, my ear infection had gradually got worse over the last 3 months,i had tingling hands and feet, gas for last 6 months and now my foreskin was sore and red, this i think is a fungal infection? and wouldnt respond to treatment,(creams or pills) and has gradually got worse to this day, just like my ear infection which has spread to the other ear. At this point i was very eager to get back to america where i could get some proper treatment and diagnosis, but i wasnt sure if i could last the 3 months it was going to take to get my wife an american visa.

I got a PCR test and a white cell count to see if i could last another 3 months, the PCR test was negative, my cd4 was higher than i expected at 616 and my cd8 390. I was surpised by this (both at lower end of range, but how common is it to have low cd'8 after hiv infection?),(also i am mildy autistic and autistic people are suppose to have lower wbc count?) I decided to go back to the place where i initially tested positive and had the test again, it was negative this time.

Then in late march i got a really bad fever (41 degrees) and my lymph node swelled up in my neck below my infected ear this lasted 2 days, and my feet and hands had no feeling for 2 weeks. I feared i wouldnt last the time till my wife got a visa. So i flew back to USA on my own. I had another antibody test in late april in a USA clinic, to my suprise it was negative, i couldnt see a specialist in USA because i promised my wife i would come back within a week. So i flew back to bangkok still stumped.

my exposures to date: march-may 2003, unprotected sex with thai girl freind, unknown status, claims she in negative. july- november 2003, unprotected sex with thai girlfreind (now my wife) tested by antibody and PCR negative.

I know that my immune system is weak becuase i am getting infections everywhere that are persistent and dont respond to treatment, i have been ill since september, i have given up with all the hospitals in bangkok and need your advice/opinion on my case.

Response from Dr. Horwath

You have had multiple HIV tests and they have all been negative. You should believe them, and ignore that first rapid test with the ambiguous result. There may have been something wrong with the test.

You should not be taking antiretrovirals. I don't know what's causing your physical symptoms, but it's not HIV. You are suffering from anxiety and should seek some help for this.

Am I at risk?

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