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Esophagus problem_what is going on?
Mar 24, 2006

Dear Dr.Bob,

I know that you receive thousands e-mails every day but anyway I would be very grateful if you could help me with my long term problem. I will try to be brief.

Recently I started having problem with my aesophagus. I feel pain in lower part of esophagus.The pain can be decsribed as feeling that something is stacked in the pipe, feeling pressure there.The pain is partly projected on my back in the middle between shoulder blade bones. It seems it getting worse as at the begining ( 2 months ago ) the pain occured but dissapeared but now it is almost persisted.This problem with food pipe started at 3,6 of the year after the exposure. I am afraid that this sometimes really strong pain is caused by candida in aesophagus.

Exposure: East Europe country _unprotected oral sex and protected vaginal sex with a worker ( the correct usage of condom is disputable as at the first she applied unknown lubricant to her vagina, then she was handling with the condom consenquently without hand washing and she put the condom to her mouth and then she placed the condom to my penise during oral sex...is this the safe method ? )

Tests: Syphils, Mononucleosa, EBV, Cytomegalovirus, Toxoplasmosa, chlamydia, gonorhea and so on...all negative, ESR normal, CBC normal repeatedly. I had six blood HIV1,2,0 antibody test in three different labs up to 8.5 months past the exposure and P24, HIV1, HIV2 negative test at 3 years mark.

Symptoms: Generalised swollen lymph nodes for more then 3 years, ( size 2,5 cm ) white tongue, tinnitus aurium, ear pain, red eyes, floaters, pain in my foots and palms like PN, often sorethroat, persistent angular cheilitis, skin problems like seborhoea dermatitis on face, trush in inguin area and perineum and between toes, GI problems ( flatulence and diarrhoea ), slight proteinuria, periocular lipoatrophy , changes in the body constitution ( more fat at bely and less fat in legs and wrists and forearms, visible veins ) The symptoms are real and people often ask me if I am all right, if I was sleeping enough because my eyes are red and I look tired and there are big dark circles around them. Very important thing is that my partner has got the same problems ( white tongue, swollen lymph nodes, periocular lipoatrofy, red eyes ) as well and her symptoms started with one month delay after major part of mine problems started at my 6th month past my exposure and persist. I am afraid that I have passed HIV virus or some other type of similar virus to her ( it is obvoiusly something contagious ). Can I rely on above mentioned collection of negative tests despite of obvious clinical problems ? Should I ask for more specific methods like (PCR, bDNA, detuned ELISA and so on ) ? My CD4 number was CD4/CD8 46/21 CD4#552 in 7 months mark and if I predict decrease 100 CD4 / year I am now somewhere about CD4#250 CD4 and candida in aesophagus would be nothing uncommon. No meds of course as there is no diagnosis.

Thank you very much for your time and your advice.

Response from Dr. Frascino

Hi,

You tried to be brief in your question. I'll be even briefer in my response.

1. Your HIV risk was minimal at best.

2. Your repeatedly negative HIV-1, HIV-2 and p24 out to three years are definitive, conclusive and excessive.

3. Whatever is causing your "symptoms," one thing that's for certain is that it's not HIV.

4. No additional HIV testing is warranted.

5. Trying to predict a CD4 decrease when you are HIV negative makes absolutely no sense whatsoever.

Bottom line: HIV is not your problem. Period. End of story. (Well, at least end of my response anyway.)

Dr. Bob



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