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co-infection very concern on results
Apr 13, 2008

Dr. Bob: Thanks for all your hard work and am a former doner, and fellow Rochesterian. I had a risk exposure with an HIV+ guy he topped me with a condum but im not sure if it broke or not, did not examine it afterwards. This was in Last week of October 2007. In November I had swollen lymphnodes, gastroenterlogic issues white coating on tongue all still present out to 6 months. In December i had fever and slight tremor, some headaches and extreemly aching knees. That said testing my GP has done is a follows: baseline antibody at 5 weeks and rna-pcr which were negative. At 9weeks and 12 weeks we did another hiv antibody and hep c antibody. Also negative. At 4.5 months he did a repeat hiv antibody and ultrasenstive prc for hiv and also a repeat antibody and prc for Hep C. Also negative. I still feel symptomatic with gastro, aching knees, continued lymph node swelling and white coating on tongue and chills. Its warming up here in Rochester but Im still waring a sweater. Could there be delayed seroconversion and thats why nothing is showing up due to hiv/hcv co-infection? Please help me sort this out and I plan on donating more to your fund its amazing what you do. Thank You.

Response from Dr. Frascino

Hello Fellow Rochesterian,

If the latex condom was used properly and did not fail, your HIV risk would be essentially nonexistent. If the condom failed and you had a significant HIV exposure you should have an HIV-antibody test at the three-month mark and if that test is negative another HIV-antibody test at the six-month mark to confirm your negative HIV status.

Symptoms are notoriously unreliable in predicting who is and is not HIV infected. I suggest you stop focusing on "symptoms" and redirect your attention to risk. Condoms, when used correctly, very seldom fail. When they do, it is not a subtle occurrence. Consequently it is doubtful your top guy's wetsuit actually failed.

Regarding HIV/HCV coinfection, you had a negative HCV PCR at 4.5 months. Consequently you do not have hepatitis C.

Regarding HIV, you've had extensive (and excessive) testing, including negative HIV-antibody tests at 5, 9, and 12 weeks plus undetectable HIV PCR RNA at 5 weeks and 4.5 months. I would interpret this constellation of negative tests to indicate you are both HIV negative and hepatitis C negative. If you continue to worry about the unlikely possibility of a broken condom, you could get a rapid HIV test at six months. Personally I don't feel it's necessary or warranted. But if this will put your unwarranted worries permanently to rest, go ahead and get it. Based on your history there is no reason you should be concerned about delayed seroconversion.

I cannot diagnose the cause of your ongoing symptoms over the Internet. However, I can with great assurance tell you what is not causing them: It's not HIV or HCV. If no physical cause can be determined for your symptoms, you should consider a psychosomatic cause. Anxiety can produce many of the symptoms you are experiencing.

I'd suggest you drive down to the lake, get an Abbott's custard and relax! I'm quite confident your worries are unfounded and that all will turn out to be "well" (including you!).

Good luck.

Dr. Bob



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