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Second Plea for Answers...Consistent with Seroconversion?
Aug 4, 2008

I recognize the wonderful humanitarian service you provide to many worried well...however must add that you have ignored my previous post. I am pleading with you to please find it within yourself to answer my questions! First of all, the background, six weeks ago I started to experience ARS like symptoms. These symptoms lasted seven days and then dissipated. After a fifteen day lull (symptom free) I experienced a papular rash (looked like tinea versicolor) that lasted ~1 day. This rash was followed (within days) by a host of other ARS symptoms (some similar to the initial bout and some additional). These symptoms have now lingered (with what I describe as 'peaks') for three weeks. Few of the symptoms ever persist for more than a day or more, yet seem to be recurring over the long period. The transient symptoms consist of sweating, neuropathy in the limbs, muscle aches, swollen glands (neck only), thrush, sore throat, chills, and insomnia. I tested negative five weeks after the symptoms began. My questions are...Q) Has ARS been known to start-stop for two weeks-and resume again like I have described? Q) Would you expect symptoms to persist for weeks or come and go individually days at a time? (example: thrush day 11 & 12 then gone until day 35, lasting for 3 days, and gone again). I have been fighting to survive the mental torment and am worried most about those around me. I am seeking your medical opinion as to the likelihood of what I describe as being seroconversion related, and would also ask for your recommendation as to the next step? I am now at a total span of six weeks of varyious daily symptoms...Q) do I wait until twelve weeks for another test?, or continue to test every week expecting the result to eventually be positive? Is there anything else I can do to end the torture of not knowing? Thank you Dr. Bob for all of the wonderful advise you provide to many...I only pray you decide to answer this post as well. Barely hanging on to hope.

Response from Dr. Frascino

Dear Barely Hanging on to Hope,

I didn't "ignore" your previous post. I read it carefully and, since I had already responded to literally hundreds of other anxious wrecks in your identical situation, I chose not to reiterate the same information over again. (I'm attempting not, to become "the Department of Redundancy Department.") A quick scan of the archives would have provided you with the information and reassurance you are so desperately requesting. Remember, there is only one of me and gazillions of "yous." I receive thousands of posts from around the cyber-universe on a continual basis. I read them all, but can only type a personal response to a small percentage.

It's unfortunate you seem to be fixated on your symptoms, rather than on your risk behaviors. In fact, you catalogue and detail your symptoms, but don't even mention any potential HIV-risk exposure!!! "Symptoms," as I have repeatedly said, are notoriously unreliable in predicting who is and is not infected. The only reason to worry or consider HIV testing is potential HIV exposure and risk, not whether or not you have "symptoms"! I also caution against self-diagnoses, such as "neuropathy" or "thrush." Unless you've been through four years of medical school, one year of internship, three years of residency (and for some of us multiple additional years of post-doctorate fellowship), you are not qualified to make these diagnoses.

Regarding HIV testing, your negative test at "five weeks after symptoms began" is encouraging, but not conclusive or definitive. I should also point out testing dates should be measured from your last potential exposure, not the onset of symptoms.

To briefly respond to your specific questions:

1. ARS's symptomatology is extremely variable from case to case.

2. Same as #1.

3. My "recommendation for next step" is simple: a) just follow the guidelines for getting an FDA-approved HIV-antibody test at the three month mark (from date of last potential exposure); b) never put yourself at risk of HIV ever again; and c) if you are "fighting to survive the mental torment and want to "end the torture," I suggest you seek psychological counseling. Anti-anxiety medications and/or psychotherapy should be able to help you confront and conquer your excessive fears surrounding HIV infection.

Good luck.

Dr. Bob



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