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Increased metaboism in ARS common?
Jun 12, 2003

Ryan,

I've got a few questions here. I'm about 45 days post (unprotected inertive intercourse) exposure, neg. antibody @7 and 35 days, neg. HIV1RNA @25.

The past 5 weeks or so, I've had aches, MUCH fatigue, malaise, some mouth sores, diarrhea, some swollen lymphs, and weight loss.

My weight loss was not because of a lack of eating, (i.e. nausea/lack of appetite), I basically felt like I had just run 5 miles the day before when I would wake up, and I would sit on the pot every moring because I was eating so much. I tried to notice any nausea, which I felt a few times througout the 5 weeks.

Normally I'm 220-225 with healthy eating/exercise. Much more if stop running.

In the 5-6 weeks post exposure, I went down to 215, but this was with no exercise, and eating everything all the time. I would have gone down to <210 easily had I kept up my normal eating habits. My face was noticably skinnier, and my shorts started to sag. What scares me is there is no way I could have run during this period, because of the fatigue.

I guess I figured, if I could overeat, then I wouldn't be experiencig weight loss, and I'd have a lesser chance of having ARS. Running would have worsened the fatigue, and weght loss, I'm sure.

Anyway, I was wondering if this type of weight loss is typical with ARS, or is it normally the nausea/lack of appetite that you'v seen in your experience?

I had already begun losing weight when I had the blood drawn 25 days after, for the bDNA quantitation. Most doctors have told me this effectively rules out ARS, since symptoms are indicative of a high viral load.

I guess I just wanted your opinion on the strangeness of the weight loss, whether you've heard of anything similar, and the timing/validity of the test results.

I guess I'm leaning towards bein positive, if I had to guess, but the test results allow me to hold out hope. It is a strange thing knowing your fate is already decided and all you can do is wait. Would you say another neg. HIV1RNA bDNA test at around 60 days would be definitive?

Lastly, why does the CDC put so little faith in viral load testing a a means of diagnosis? I thought it was because of false positives? How common are false negatives?

Thank you for your time and patience, any information you can give me helps me, even though can't do anything but wait. Keep up the good

Response from Mr. Kull

I can't tell you what your weight loss is related to, and it seems like you are going through a lot of anxiety trying to detect whether or not you are HIV infected based on symptoms that you may or may not be experiencing. I'd be more concerned that your weight loss and other symptoms that you experience would be related to anxiety and/or depression. Regardless, you should be talking with a doctor, in person, about this stuff.

PCR RNA tests are highly likely to detect virus during acute infection. The CDC does not recommend PCR testing for cases like yours because the FDA has not approved it for such purposes. However, you should only rely on PCR testing in consultation with your doctor. It's only necessary in certain situations, and you run a greater chance of getting a false positive when compared to antibody tests. An experienced clinician should be ordering and interpreting these tests for you.

Please consider talking with someone about your anxiety, regardless of whether or not you believe that you are HIV infected. It sounds like you are having a really difficult time, and you deserve to feel better.

RMK



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