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Strong possibility of HIV +?

Jan 10, 2007

Hi Robert, you are my idol. Because of your hard work and generosity, I have decided to become an infectious disease specialist like yourself. I just have a quick question

Had oral sex + fingering with a girl that had one previous partner (in mid Aug). Developed a fever + diahhrea the next day that went away with sleep. Got scared when I saw a white tongue with lesions on the side but I felt fine (checked in dental "nothing remarkable"). Exposure was on Oct. 31. I feel OK (besides the fact that I only sleep 5 hrs/night) Up until December 28th or so where I felt very weak and had muscle aches only in my neck. Noticed that I started having sebhorreic dermatitis , cervical lymph swelling etc. I thought I was in a stage of advanced AIDS until I learned my t-call count was 680/42%. Took 2 HIV tests both neg. Partner who performed oral sex took test recently (Jan 9. , tested -, her last possible exposure was Aug. 15th. Waiting for viral loads and HIV-2, how it lookin' doc?

Response from Dr. Frascino


How's it looking? It's looking like you're getting way too many completely unnecessary tests!

Your HIV risk is very low. Your symptoms are not worrisome for HIV ARS. The only test recommended would be a single HIV-antibody test at the three-month mark.

Your two negative HIV tests within the three-month window period would be considered encouraging, but not definitive.

Viral load tests are not indicated for routine screening, due to the rate of false-positives, other technical considerations and cost. HIV-2 wasn't really indicated.

That your partner also tested HIV negative on January 9 gives further corroboration to your not even being exposed to HIV.

If you really are going to become an infectious diseases specialist, all I can say is that you have much to learn.

My recommendation is to get a single HIV-antibody test at the three-month mark to confirm what I very strongly suspect: you are definitively HIV negative. Then yell WOO-HOO and after that, feel foolish for wasting time, energy, blood and money unnecessarily on all your previous tests.

Dr. Bob

Probability of infection
Viral Load accuracy

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