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Donation for reply......very desperate......please dr bob
Jan 19, 2007

Hi Dr. Bob

I have been trying to write to you with this question for the last 3 weeks and am desperate for an awnser. I know you are very busy and i respect the work you do on this site but I fear you do not want to respond because you think I really do have HIV. I have never read a post on here of someone writing in with many many symptoms and you telling them there they probably have HIV. I will do anything for a response please....im begging you. Ill do my best to keep it short.

Risk: Im 22/male and had unprotected sex with a female 10 weeks ago.

As a note I have had some dry patches of psoriasis on my penis for about a year. There are some abrasions and the skin looks red and irritated at times, however there has never been any bleeding or anything like that so I assume the skin is relativly intact.

Symptoms 4 weeks after possible exposure: flu like symptoms, extreme fatigue, a few night sweats, yeast on my tongue, 2 or 3 small, painful, white bumps on the roof of my mouth right behind my front teeth, bleeding gums, canker sores, loss of appetite for a few days, some diahorrea, and muscle aches.....(I did not have skin rashes, weight loss, or any cough though).

Most symptoms went away after about a week. The only ones that continued were extreme fatigue, muscle aches, some thrush, and dry mouth.

7-8 weeks after possible exposure: Developed pain in my hands and feet. (mostly feet) Hot/cold feeling, trouble walking sometimes, tingling, hands fall asleep at night sometimes while im sleeping. Feels like nerve pain on the bottom of my feet. Affects both feet pretty equally except there is more pain in the heel of my right foot than in the left which is why I have trouble walking. Legs feel extremely heavy at times.

Testing: 36 day negative test. Waiting to go back in a few weeks for the 3 month test.

Here is my list of questions:

1) Would the psoriasis on my penis greatly increase my risk of transmission?

2) I know symptoms dont diagnose HIV and you say to stay away from the internet but I didnt even know about ARS before my intial symptoms started so its not caused by anxiety. Could this be anything other than HIV? The symptoms of ARS seem pretty clear and when you get almost every single one like I did there is no other viral infection that really matches up, at least not that I can find. Am I misinformed?

3) Have you ever had a patient with every symptom of ARS after a high risk exposure within the window period of ARS and test negative? Because I have basically diagonsed myself.

4) Do symptoms of ARS all go away at the same time or do some go away while other linger? Because like I stated above, most symptoms went away but fatigue, thrush and muscle aches continue.

5) Could peripheral neuropathy happen already after only 2 months of having the virus? I have read that most people dont develop symptoms for 3-7 years after acute infection. Does this make me a rapid progressor? I dont know what else could be causing neuropathy.

5b) If this is HIV related neuropathy, that means my cd4 counts are under 200 correct? If I were to start medication to get those numbers above 200, would the neuropathy go away or would I have it forever no matter what I do?

6) I know a 36 day negative doesnt mean anything and that I have to retest. 3 month is 99.9 percent, right?

7) A cure is kind of a stretch considering no cure for any viral infection has ever been found. But do you think that new therapy within the next 10-15 years will be able to keep this virus at bay for a persons entire lifespan without many complication or side effects?

Thank you for any help or advice you could provide me.

Response from Dr. Frascino

Hello,

The reason I have not responded to your previous questions is that the answers are already in the archives. Consequently, I'll respond only briefly to your seven specific questions:

1. Only if the affected areas were inflamed or the skin was not intact.

2. Yes, it could and most likely is something other than HIV. Yes, you are misinformed.

3. I don't test people in the window period and I strongly advise against self diagnosis.

4. HIV ARS symptoms very greatly in severity and duration from person to person.

5. What you describe is not HIV-related peripheral neuropathy.

6. No. No.

7. Yes.

8. Sorry, not even I have a crystal ball that can accurately predict what will happen 15 years from now. (I would have never guessed Dubya could have been reelected, so . . . .)

Bottom line:

1. You placed yourself at risk for HIV; therefore, you need an HIV test at the three-month mark, whether you have no symptoms or every symptom in the book.

2. Symptoms are notoriously unreliable in predicting who is and who is not HIV infected.

Good luck!

Dr. Bob



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