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autoimmune + HIV
May 21, 2008

Hi Dr. Bob,

I have read through some of your archives but I am unable to find an answer to the question I have.

Recently I was diagnosed (by Emergency doctor) with a guillain barre type illness GBS - (leg mucle pains, tingling in the legs and face). I had a throat infection about 8 weeks ago that might have triggered it. More importantly I had a sexual exposure (protected (not sure what the condom type was as she provided it) vaginal + unprotected oral on a female) around that time and I am deeply concerned that the throat infection + GBS was possibly due to acute HIV.

Since then I have been scrambling to research what impact guillain barre has on the HIV window period as it is an autoimmune disease. Please help doc as I am panicking.

1) Is GBS more likely triggered by acute HIV than another other infection?

2) What impact does GBS have on immune response to a foreign invader if the body turns on itself (maybe you can describe what happens in GBS). Does the body stop (or slows down) producing antibodies to the foreign invader and concentrate on attacking itself?

3) Does GBS impact the HIV testing window period because of question #2 or any other reason? I.e. Would 3 months definitive still apply? I have an 8 week negative antibody test but the internet is full of information that GBS during acute HIV can slow the body's ability to produce antibodies.

As an HIV specialist and Immunologist you are the only one I can turn to for valuable insight. My General Physician is not very familiar with GBS. I have further testing with my neurologist in 1.5 weeks. A greatly appreciate your help doctor as I have no one else to turn to. I promise to donate $100 to your foundation.

Hi Dr. Bob,

I hope this message finds you in good spirits (wait u'r always in good spirits - thats what we love about you). As for my issue - I have read through some of your archives but I am unable to find an answer to the question I have.

Recently I was diagnosed (by Emergency doctor) with a guillain barre type illness GBS - (leg mucle pains, tingling in the legs and face). I had a throat infection about 8 weeks ago that might have triggered it. More importantly I had a sexual exposure (protected (not sure what the condom type was as she provided it) vaginal + unprotected oral on a female) around that time and I am deeply concerned that the throat infection + GBS was possibly due to acute HIV.

Since then I have been scrambling to research what impact guillain barre has on the HIV window period as it is an autoimmune disease. Please help doc as I am panicking.

1) Is GBS more likely triggered by acute HIV than any another infection?

2) What impact does GBS have on immune response to a foreign invader if the body turns on itself (maybe you can describe what happens in GBS). Does the body stop (or slows down) producing antibodies to the foreign invader and concentrate on attacking itself?

3) Does GBS impact the HIV testing window period because of question #2 or any other reason? I.e. Would 3 months definitive still apply? I have an 8 week negative antibody test but the internet is full of information that GBS during acute HIV can slow the body's ability to produce antibodies.

As an HIV specialist and Immunologist you are the only one I can turn to for valuable information. My General Physician is not very familiar with GBS. I have further testing with my neurologist in 1.5 weeks. But I am desperate for your expertise and would grealy appreciate your feedback doc on my questions. I promise I'll do anything you say do. I'll run laps around the high school track, I'll walk the old lady down the corner to get her mail, I'll even do jumping jacks down the street if you reply. Thank you so much doctor.

Response from Dr. Frascino

Hello,

First things first. You report the ER doctor diagnosed you with a "Guillain Barré type illness," possibly triggered by a throat infection eight weeks ago. I would strongly suggest you consult a neurologist to determine if indeed this is Guillain-Barré or not. (Eight weeks would be considered a long interval for a triggering event. Generally it's three to four weeks.)

Regarding your HIV-acquisition risk, protected sex would be "protected" if the latex condom was used properly and did not fail (break). Lambskin or natural condoms would provide protection against unwanted pregnancy, but not HIV. Oral sex carries only a minimal risk for HIV acquisition.

To specifically address your questions:

1. No. It's a relatively rare disorder and still incompletely understood.

2. Guillain-Barré is an uncommon inflammatory disorder in which the body's immune system attacks part of the peripheral nervous system, causing varying degrees of weakness or tingling that usually starts in the legs and in many instances spreads to the arms and upper body. Eventually the entire body can become paralyzed. The exact cause of Guillain-Barré is unknown. Most people recover completely from even the most severe cases with supportive medical care. This type of autoimmune process would not affect routine anti-HIV antibody production.

3. No, Guillain-Barré would not affect the HIV window period. Yes, a negative three-month test would still be considered definitive.

Thank you for your generous tax-deductible donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). Your one gift will touch many lives. And yes, you should walk the old lady down to the corner to get her mail. In addition I expect you to do jumping jacks down the street while yelling WOO-HOO when you get your definitive three-month negative HIV test results (and recover from Guillain-Barré if that's what you have). I'm sending you my good-luck karma that your three-month test remains negative and that you recover quickly and completely from your other ailment whatever it turns out to be!

Good luck.

Dr. Bob



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