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oddball infection (again)
Dec 24, 2007

Hello again, Dr Bob. I really wanted to ask your opinion as an immunologist on my problem. Sorry, I was a little tipsy when I posted my original question, so I got a little muddled. I have accepted that HIV is not the cause of my symptoms. Negative at 8 1/2 years with a normal CBC is a pretty good indicator by anyone's standards. I only got hung up on the possibility of HIV in the first place due to the alarming similarity of some of the symptoms (esp the ongoing lymph node involvement and night sweats). When I think over this in my more lucid moments, I realise there were differences between the symptoms (notably the absence of fever and the prolonged initial symptomatic period). Regarding your recommendation that I should seek counselling/ psychotherapy; I already did, five years ago. I was on a high dose of Prozac for 18 months, which helped my anxiety/ HIV worry but did not alleviate the physical symptoms. My psychiatrist obtained my lab records from the infectious disease unit, and said that my normal blood count w'diff, normal blood chemistry, CRP, ESR, were unambiguous evidence that I did not have an infection. As an immunologist, would you agree with this statement? It seems to me that, while these results exclude the possibility of many infections, some people with bloodborne pathogens can still have perfectly normal blood counts. I'm sorry to take up your time again, but the similarity to some of my symptoms to HIV is really scaring the bejesus out of me; while I know that I have absolutely no chance of being HIV-positive, my suspicion is that I have picked up some kind of persistent virus, as yet unidentified. Were I the only person with these symptoms I might have accepted that this is all in my mind, but as I said I have passed this on to at least two people, who developed the same ongoing problems. This recent weight loss has really thrown me, but my doctor just sent me home with my recent normal CBC/ chem results. I would really appreciate your opinion on what the odds are of my having an ongoing infectious process which would not cause anomalies on the tests I took. Thanks for your advice and I hope you have a great Christmas and New Year.

Response from Dr. Frascino

Hi,

I absolutely agree with your physicians. Your labs show absolutely no indication of an infectious process. Do I think you could have a persistent yet unidentified virus? No, I do not. Do I think you passed this nonexistent infection on to two other people? No, I do not.

As for your weight loss, this is a common symptom of depression and anxiety. I again urge you to stop chasing after a nonexistent infection and consider getting additional psychiatric help.

Happy Holidays.

Dr. Bob

hiv or oddball chronic infection? Dec 22, 2007

Hello, Dr. Bob, hope you are doing and feeling well. I hope you can give me some good advice on this one; I'm at my wit's end . I'll try to summarize as best as I can. June 1999, condom split with suspicious female. 2 days later, I developed balanitis which took nearly a year of canesten treatment to clear up. 16 days p/exp I woke up with 'pulling' feeling in left armpit, which, over the next few days spread to my chest wall/ right armpit. No fever, but night sweats/ chills. No sore throat. tender points/ lumps popped up all over the place in the next few months (was still getting new ones in extremities 4 months later). Migratory joint pains in first few weeks, which have not returned. Geographic tongue developed and persists. First std clinic visit (6 wx p/exp), sugar found in urine but no diabetes on follow-up test (persists). was not present months b/exp on routine test. Months later, found to have high-frequency hearing loss (again, not present b/exp). stale smell in right nostril/ black snot (persists), severe fatigue (esp trapezium muscles) for approx 10 months which suddenly resolved. Shin splints when walking for 1st year approx. Recurrent cystitis (pre-existing prob) became much worse in first few weeks p/exp, then cleared up and now hardly ever occurs. Liver pain at 5 months, dark urine, recurs. Nasal allergies, bad gums etc. Small yellow bruises on shins without injury are frequent. No weight loss at initial stage. Acne from teenage years resurfaced. Full STD check at 3 months was negative, including HIV (3rd gen ELISA). Lymph nodes have never returned to normal, but are now on large end of normal size range and mostly rubbery/ nontender, becoming tender in various sites from time to time (anywhere in body). Complete blood count at 7 months normal. Infectious disease screening (EBV, CMV, HCV etc) at 18 months all clear. CBC/ chemistry normal except positive for 2 types of autoantibody (can't remember which). Repeat serology for HIV at 21 months (I know, I know) was nonreactive. Lymph nodes/ recurrent night sweats/ recurrent liver pain persist to this day. Unfortunately, approx 8 wx p/exp, I managed to infect a friend through an open cut (handling sharp object), who developed night sweats/ tender lymph glands/ the lot 3 wx later and has never been well since. 2 1/2 years p/exp this happened again, flatmate developed the same symptoms in spite of my hygiene measures . 8 1/2 years into this nightmare, and I have lost a lot of weight/ hair this year. Sleepy all the time, low volume of semen production, depression, weakness in limbs etc. Last week I bought a finger-prick test on the net (HIV 1/2/o), which came back negative. My latest complete blood count (today) came back normal. It's been 8 1/2 years, and my nodes have never returned to normal. I can't get further investigation on account of my normal blood count, but am still ill and so are my friends. Can you advise on other possible infectious causes for this (other retroviruses etc)? Could I have HIV for 8 1/2 years and still expect to have a normal blood count? Have I murdered my friends without meaning to? Please help me, I'm desparate beyond description for my friends and myself.

Response from Dr. Frascino

Hello,

Multiple HIV-negative tests out to 8.5 years and you're still worrying about HIV??? And now you've expanded that paranoia to include anxiety about inadvertently murdering your buddy and his flatmate with your nonexistent HIV infection???? The title of your post is "HIV or oddball chronic infection." I would have to opt for the second alternative: "oddball chronic infection," but curtail it to only "oddball!"

Dude, ok, you had an HIV risk when your condom failed back in the Clinton Era, but your multiple negative tests since then are absolutely definitive and conclusive. HIV is not your problem. No way. No how. The "symptoms" you reported black snot (ick), severe fatigue in "trapezium" muscles for 10 months, shin splints, high frequency hearing loss, etc. have absolutely nothing to do with HIV disease!! I can't diagnose the exact cause of your past symptoms or any current ongoing or recurrent problems over the Internet. But what I can do is advise you with certainty what is not causing those symptoms: It's not HIV. If your physicians have not been able to find a physical cause for your symptoms, you should consider a psychosomatic cause. You should also definitely get a referral for psychological counseling. Your fears and perseverations on HIV, a disease that you could not possibly have, are irrational.

Regarding your friends, again I cannot diagnose the exact cause of any of their ailments over the Internet, but I can assure you with complete confidence that you did not transmit HIV to them. Why? Because you do not have HIV!

I absolutely agree you should go no further in your "investigation" of HIV; however, evaluation and treatment of your unwarranted and irrational fears and delusions of HIV and HIV transmission are indeed warranted! If indeed you are "desparate" beyond believe (and I believe you are), stop chasing an illness you do not have and get the help you desperately need.

The road back to health, both physical and mental, is clear, but you have to get off the wrong path you are currently following and take the first steps in this new direction.

Good luck.

Dr. Bob



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