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symptoms to positive result time
May 15, 2008

Hello Dr Bob,

I see how many posts you make in a day, you sure are busy! I hope you have some time to look over my question. I'm a sexually active gay male, I never have unprotected anal sex. Last November I started developing pain in my groin. I was already a little nervous about sex I'd had with a guy I didn't know well, because when I was giving him a blow job I got some precum in my mouth. I went to get an HIV test about a month after I first noticed the painful lymph nodes in my groin, and I had another test one month later. the second test was over 3 months from that particular exposure, but in the time between meeting that guy and noticing the pain in my groin, I met perhaps 3 other guys and had protected anal sex with 2 of them, and unprotected oral sex (although I was careful not to get any precum in my mouth those times.) To this day, I still have painful lymph nodes in my groin, and Although a urologist has said they are within normal range,my GP disagrees. I was then found to have some white blood cells and protein in my urine, and was prescribed antibiotics for a week. After taking the medicine, the pain persists. So here are my questions: 1. Would an ELISA test be likely to show positive 8 weeks after swollen lymph nodes and fever associated with ARS occurred? I know it is sometimes called "seroconversion illness" because it coincides with blood tests being able to pick up antibodies.

2. I read that protein in urine is common in people with HIV due to kidney damage, but is that the case from the very start, or is it something that occurs later in the stage of the illness? And could the white blood cells also be of significance? and Finally,

3. is it usual for someone to develop painful lymph nodes with ARS which don't go away for 6+ months?

Many thanks..

Ps, if you know anyone selling votes for the US election on Ebay, pass them my email address, as a European I think it's unfair not to get a say on who rules the world! (I would of course use it to vote Barack!)

Response from Dr. Frascino

Hi,

How busy I am is tied directly to how many anxious nervous wrecks are clamoring for a specific and personalized response to their usually unwarranted worries about a sexcapade with the Naughty Lady (or Laddie) of Shady Lane. Of course, if they would check the archives instead of writing to me every 10 minutes, threatening to kill themselves if I don't respond within the next nanosecond, they would be pleasantly surprised to find that I have indeed already addressed situations extremely similar to their romp with the barely legal French prostitute who had a penchant for narcolepsy and fetish for doing it in the reverse cowboy position while going 60 miles per hour downhill in an out-of-control luge. But alas, I digress . . . .

Responding to your specific concerns:

1. The vast majority of HIV-infected folks will have detectable levels of anti-HIV antibodies in their blood within four to six weeks. Occasionally it can take longer. The current guidelines continue to recommend testing at the three-month mark for a definitive result.

2. The vast, vast, vast majority of folks with protein in their urine do not have HIV disease! There is no doubt that white blood cells and protein are abnormal findings on a urine test and should be evaluated and treated. Immediately jumping to the conclusion they might be HIV related is more of a quantum leap that makes absolutely no sense whatsoever! You've had negative HIV tests more than three months after your potential exposure. That result is definitive and conclusive. HIV is not your problem. No way. No how. Whatever is causing your urine abnormalities, one thing is certain: It's not HIV! Follow up with your urologist regarding your abnormal urine test.

3. The adenopathy (swollen lymph nodes) associated with HIV disease is generally non-painful. In your particular case, even this is a moot point, because you are definitively HIV negative, remember?

As for votes for sale, well that's usually a Republican strategy, but even that is not going to help them this time. The GOP is going down (and not in the good way either!).

Dr. Bob



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