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Don't know what to make of all this - PLEASE HELP!

Dec 10, 2006

Dear Dr. Bob:

I have been visiting this site for several months now and I am simply amazed by the great work you do for all, answering questions and fighting the good fight. Your life is absolutely an inspiration to me.

I am trying desperately to find some closure to an ongoing concern Ive had about possibly acquiring HIV. I would appreciate your advice. I apologize for the length of my story, but I believe that it provides important detail.

I am a 36 y.o. male heterosexual, 36. In early March 2006, I had an unprotected sexual encounter with a woman whom I met in a bar. We engaged in both vaginal (about 10 min.) and oral sex (about 5). About 3 days later, I began to feel very tired. The day after that, I came down with some harsh exudative tonsillitis, along with a fairly high fever. Went to the doctor who did a strep test it was negative. I was put on a 10 day course of antibiotics and prednisone. While taking the medication, I had a couple evenings of night sweats, but felt better after a few days. About four days of completing the medication, I came down with another round of exudative tonsillitis and fever (about the same severity as before). This time I went to an ENT, who gave me a monospot test negative. He put me on another 10 day course of antibiotics (a stronger one) and prednisone. Had a couple of night sweats again, but not as severe as before. My ENT ordered a CBC and it came back with a WBC of 17k, but a 6% lymphocyte count (about 1020-1050). Again, I felt much better after a few days of meds. Near the end of finishing the second round of meds (now three weeks post-incident), I had a day of pain behind my eyes with slight dizziness and nausea. A few days later, I started seeing waves/floaters in my field of vision. I went back to the ENT for follow-up to my tonsillitis and he then diagnosed me with nasal polyps. At about this time (4 weeks post incident), I began to consider the possibility that what was going on was related to my unprotected encounter. I had lost about 15lbs. (from 175) during the two rounds of tonsillitis. I was able to locate and contact the woman whom I had the encounter with. We spoke several times over the course of the next two weeks and each time she said that she did not have HIV. My last call with her ended no to great I expressed doubt in her veracity and she said Youre so convinced Im HIV positive. Ill tell you what you keep testing and testing until it turns positive, but it wont be from me.

I had the nasal polyps removed about the middle of May. At the end of May, I went to the eye doctor for my vision problems and was diagnosed with a vitreous detachment. It was at this time (about 8 weeks post) that I began HIV testing. Over the course of the past 8 months, I have been:

Ora-quick Advance 1/2 rapid finger (blood) tested about nine times (at the 8, 12, 15, 18, 25, 27, 29, and 34 week mark) at a local HIV clinic all non-reactive/negative Orasure Oral swab HIV Antibody test at the week 25 mark non-reactive/negative Blood draw HIV ELISA test by my GP (Quest), private service (Labcorp), and local HIV clinic (at the 19, 23, and 25 week mark) all non-reactive/negative HIV/DNA by PCR test by a private company (Labcorp) at the 23 week mark non-detected HIV/RNA by PCR by local HIV clinic at 8 months non detected (under the reference range of <400 copies) CBC by GP and local HIV clinic. Normal values. However, my WBC count was most recently (August 30) down to 4300 with Lymphocytes at 36%

Over the course of these 8 months, Ive had some other troubling symptoms, such as: fatigue; what looks to be like minor folliculitis on my scalp (sorry for being so graphic, but when I pick at the bumps, I notice a very small hair in the pus); sides of my neck are itchier than normal, especially after working out; skin in neck, face, and scalp areas in general is redder when scratched, the red scratch lines take longer to go away; and an increase in small red spots that dont go away. Also, for about the last six weeks Ive experienced a tingling/burning sensation on my tongue, waking up each morning with a pasty film on it, and have moments when my mouth is very dry what spittle I can muster resembles white foam. I admit that I have been very stressed out and anxious about this whole experience. My GP put me on Lexapro but that only bothered my stomach and made my mouth even drier. It didnt seem to get my mind off things, so I stopped taking it. I eat very healthy, but have about 1-2 drinks a night, and probably dont drink the recommended amount of water each day. I also work out about 2-3 times a week.

In light of the information above, my questions are:

1. What is the window period for a person with my noted risk? 2. Are my initial (March 2006) and most recent CBCs (August 2006) suggestive that I experienced ARS? My initial WBC was 17000 and lymphocyte % was 6%, but is more recently 4300 and 36% respectively. Would the 6% lymphocyte indicate that my CD4 cells dropped dramatically? 3. Would my drinking habits and lack of normal water intake, impact on the time it takes to seroconvert, if positive? Would it extend the window period? 4. Based on the current troubling symptoms, would you recommend additional testing? If so, what? Would a CD4 count be helpful? 5. In general, is there any other test I could take at this point that would be 100% conclusive (at eight months), and get me over my continuing doubts about my previous testing results. A NAT or some other newer test I havent heard about? 6. Am I out of the woods? Can I WA-HOOOO?

I have been very healthy prior to this year. I dont want to be a burden on the local HIV resources and the folks who really need it if I truly dont. But all of this seems more than just coincidence, and I can only take than woman at her word I dont have any proof from her in writing. I hope you can help me understand this and figure out what to do next. You are the best. Thank you for your time.

Response from Dr. Frascino


I'll start with my conclusions: HIV is not your problem. No way. No how.

A negative HIV test outside of the window period trumps any and all symptoms each and every time. (Or in your case, 15 negative HIV tests!!!!!)

To specifically address your six questions:

1. Window periods are always the same. HIV-antibody tests taken prior to three months are not considered to be conclusive or definitive.

2. No. (No way. No how!) No. (No way. No how!)

3. No. (No way. No how!) No. (No way. No how!)

4. No. (No way. No how!) No. (No way. No how!)

5. No. You are HIV negative. Of that there is irrefutable evidence. There can be absolutely no doubt. Therefore there are no tests needed and unfortunately no tests that will "get you over your continuing doubts . . . !" For that you will need psychological help, not more testing.

6. You are so far out of the woods that you're barely still in the same galaxy! Your testing has been impressively excessive and unnecessary!

Can you WOO-HOO??? All I can tell you is that there is absolutely no reason why you shouldn't have been WOO-HOOing many moons, many blood draws and many dollars ago! So can you WOO-HOO??? I don't know. Can you?

Dr. Bob

Need Assurance from most recognised HIV specialist
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