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Please point me in the right direction

Jul 25, 2008

Hello Dr Bob. Firstly may i say what a fabulous job ou do & will make a donation regardless of wheter you answer my questions.

Please can you ascess my current predicament & give me some advice.Had 2 episodes of unprotected vaginal intercourse a few months ago one of which involved a cut on the head of my penis.Aboutight to ten days after this I started to feel unwell.Symptoms as follows:swollen glands in neck & groin-weakness & pai in legs-loss of appetite-uncomfortable feelinf under ribcage rapid weight loss-frequent urination all day & night-unable to get an erection-diorehha-chills & mild fevers-clumsiness bumping into things-speech problems-ear pain-dissiness-eyes sensitive to light-red sunburn like rash on stomach,back & face-pain in extremities-costant dull headache-mild sore throat.All the above I still have to this day some 20 weeks post exposure although they have somewhat abated around 8 weeks post exposure but have slowy gotten worse again .During the last couple of weeks a pre-existing medical condition, reiters syndrome has reactivated again & is becoming predominately worse.The rash as mentioned above tends to come & go also.I have had the 4th generation antibody/p24 antigen tests done at the following timelines:10 days-6 weeks-13 weeks-19 weeks post exposure which have all thankfully come back negative.Have been tested for syphillis,hepatitis also.Have had 2 complete blood counts done which were all in normal range.I cannot carry on as I am,most days are a struggle to get through then I can have a few days where I feel relatively ok before going off again.I have asked for a viral load test at my local clinic but was refused as these are only for confirmed HIV positive people.I am completely lost & dont know where to turn too next.I have a history of going to see the my GP especially after always having a prolonged inflammatory response to an infection which was never diagnosed although as the years have elapsed the reactions have subsided somewhat to when I first used to get them & in the last coulpe of years have had a frequent outbreaks of a fungal infection petiscolor versicolar which clears after using cream. Please could you answer me the follwing questions: 1.Should I still try to obtain a viral test given my clinical history. 2.Would the P24 antigen have been picked up if antibodies are not present. 3.Should I forget all about HIV & pursue another cause too my endless list of symptoms.

Many Thanks A UK friend.

Response from Dr. Frascino

Hello UK Friend,

1. No. I absolutely agree that HIV plasma viral load tests should not be done for routine HIV screening. They were never designed for that purpose. Your repeatedly negative HIV tests out to 19 weeks post-exposure are definitive and conclusive. HIV is not your problem.

2. If you were HIV positive, your p24 antigen would most likely be positive. However, you are not, so it is not!

3. Absofrickinlutely! Whatever is causing your symptoms, one thing is certain: It's not HIV! No way. No how. Although I cannot diagnose the exact cause of symptoms over the Internet, it is possible many of your complaints could be caused by the flare in your Reiter's syndrome. Plus, some of your symptoms may be caused by anxiety and related to your fears of being HIV infected. Perhaps counseling would help. Also, a rheumatologist would be the best specialist to see for Reiter's syndrome.

Thanks for your willingness to make a donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Dr. Bob



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