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Dr. Bob, please read, only one chance please
Dec 1, 2008

Hi Dr Bob, this is the 3rd time Im writing to you, I really need your feedback please. Not sure if you remember me, I had a high risk exposure in Bangkok over 4 months ago, you have replied to my first msg on Oct 26th I need your help please was the title. Anyway just want give you quick update, after the 8 weeks RAPID test, I have had my 3 months RAPID test which came back negative and 15 plus weeks ELISA test also came back negative, the doctor performed Chlamydia and Gonorrhoeae and also they came back negative, however EBV IgG came back positive in Anti-VCA gp125, Anti- VCA19, Anti-EBNA-1 and Anti-P22. Also my lymphs are still painful mainly in my groin and armpits and lymph groin is about 0.68cm to 1.57cm, the doctor sent me to laboratory where they did (fine needle aspiration) and found consistent with reactive lymphadenopathy . The doctor said nothing serious but there is infection not sure, maybe related to EBV. Doctor, Im still experiencing headache, itchy and painful eyes, my face and my whole body itch, rash on my face, tender lymph nodes in my groin and armpits and fatigue. What should I do next? I have been sick for the past 5 months, this is effecting my life and work, not sure if its due to the EBV, the Doctor said, the EBV infection probably acquired at least two month ago, should symptoms last this long? Im still worried about HIV since my risk was very high possibility of unprotected anal sexy (I was drunk and passed out) that I have received from guy sexy worker. Please let me know what you think and what steps I should take next. BTW, Im coming to the US around mid December and promise to donate and send a check from my American account there. Thanks

Response from Dr. Frascino

Hi,

Welcome back to the forum. I'm sorry you are not feeling better yet. I am still not at all convinced you had "unprotected anal sexy" in your drunken stupor. (See below.) However, even if you did, your repeatedly negative HIV tests out to 15+ weeks are definitive and conclusive. HIV is not your problem. No way. No how!

I agree with your doctor EBV (Epstein Barr virus) is the most likely culprit to explain your reactive lymphadenopathy, fatigue and other symptoms. EBV can cause a very protracted illness, but its symptoms generally do abate. Your ongoing worries that this could still be related to an HIV infection are unwarranted.

Your next steps are:

1. Stop worrying about HIV.

2. Rest, eat well, exercise in moderation and lead a healthy lifestyle while you recover from your EBV.

Thank you for your desire to donate to the Robert James Frascino AIDS Foundation (www.concertedeffort.org).

Be well.

Dr. Bob

I need your help please Oct 26, 2008

Hello Doctor, About 3 months ago in Thailand I got stupid drunk and came to my hotel with sex worker which looked like a women to me at the time but remember he was a gay man before I passed out. I remember few things, the person licking my anal, we did not have condom so we had anal sex, I didnt remember receiving but in the morning when I woke up the person was gone and there was little blood and other stuff on my bed, so I believe after I passed out, I probably received anal sex but cant remember. About a week later, I had symptoms like, no energy, lost appetite, rash on my face, pain in right side and lumps grain that could be felt, low grade fever, I have lost about 10lb cause I didnt feel like eating anything, this lasted for over two months. Now it has been 3 months and for the past week I have been experiencing dry itchy eyes and pain which grows to my sinus and headache to under my eyes and neck pain. Also I have had clear discharge that is not going away since the exposure. I have been to the doctor about a week after the exposure, they did urine and some other test for STD, all came back negative, also test for VDRL at one week and 3 weeks all negative. I have also taken HIV antibodies test here in Asia at 4 weeks and then 8 weeks all negative, because I wash in rush they gave me the second result in an hour, is that reliable?, what do you think about the results, is it too early? About my clear discharge that wont go away, Im seeing the doctor almost every week and he refused to give me any antibiotics, he says I dont have any STD at this time, he says, it will be severe if discharge lasted for over two months, he gave me medicine which I looked up and its for anxiety, I have serious symptoms not sure what Im missing here. What do you think doctor, Im 30 years old male never had sex with guy person before, I got stupid, got drunk and lost control, I was in perfect health before 3 months but lately I cant even focus at work, I have all kind of symptoms, I dont have energy by 5pm, i never have headache in my live but lately my eyes and the bad headache are killing me, please help me.

Response from Dr. Frascino

Hello,

OK, so you may have wound up getting banged on your "one night in Bangkok." I'm a bit confused by your statement, ". . . we did not have condom so we had anal sex . . . ." Hmm . . . that is indeed "stupid" drunk!

If indeed you have never had sex "with guy person" before, chances are if you did have receptive anal sex, you would have felt it the next day.

Regarding "symptoms," they are notoriously unreliable in predicting who is and is not HIV infected. Your negative HIV tests at four and eight weeks are extremely encouraging, but not definitive yet. For that you'll need to be retested at the three-month mark.

Many of your symptoms (inability to concentrate, fatigue, headaches, etc.) may well be related to stress (anxiety, depression, guilt). Continue to follow up with your doctor regarding your "clear discharge." I absolutely agree with his decision not to prescribe antibiotics, considering all your screening STD tests are negative.

Take a read through the archives of this forum. The information and testimonials you'll find there should be both enlightening and reassuring to you.

Good luck.

Dr. Bob



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