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Not Thomas from Germany
Dec 16, 2008

Hello Dr Frascino

I will try and make this short. My situation I guess is not disimiliar to Thomas from Germany. I had a high risk exposure in June 2004. Out celebrating graduation, I ended up having unprotected sex with a commercial sex worker. I came down with all of the symptoms of ARS and it was only when I looked them up on the net that I then realised that it was seroconversion.

For the last four and a half years my symptoms have been endless. It is stuff that I never had before. Rosecea diagnosed by my eye Doctor, seborhea dermatitis, constant film on my head, and a bad case of ring worm. All this was diagnosed by a health care professional. The most worrying thing has been the candida, thrush and psoriasis also diagnosed by a doctor. Something which reminds me of my situation everyday is the distal banded finger nails that I have. Having looked these up extensively I have come to the conclusion that these are also psoriasis induced.

I regularly go for dental check ups every six months. Last month when my dentist checked me over he sat down flabergasted and said that he had never seen anyone go from perfect teeth to having advanced peridontal disease within six months like I have.

The testing that I have had involve ELISA's at three, five, six, ten, sixteen months and about two years after exposure. I believe that at least some of them were for HIV 1, 2 and Group O. At two and a half years post exposure I had an inhouse Proviral DNA for HIV 1. This was for the env, gag, LTR and pol regions of the virus covering HIV 1 group M, subytpe A-G and Group O. This came back non reactive, but the results said for DNA and RNA, what is that about.

I have also unfortunately fallen into the numbers game in terms of CD. At two and a half years post exposure my CD count was 610 at 46%. Then at three years post exposure it was 610 at 38%, then at three years and three months it was 790 at 42%, then at three years six months it was 635 at 36%, then at four years it was 650 at 36% and just recently at four and a half years it was 575 at 34%.

As you can see the CD has been declining and certainly the percentage which should be stable over time has really depleted outside of the normal variability. This whole time I have had a ratio of at least 1.5. What worries me is that at only six months past exposure I had a complete blood count that gave a lymphocye count of 3000, that is almost 1000 plus what it was in the above, could that have been a transitory CD 8 inversion.

Sorry this is so long, but I have looked in the archives and the most similiar is Thomas from Germany. If you don't want to give a comprehensive commentary on my situation and I don't blame you, could you please just tell me that your advice is the same as that given to him.

I don't need psychological help, I am pretty philisophical about this. I have given up on life and am happy about that. I have lived a life of celebacy since June 2004, despite my doctors advice that heterosexuals don't get HIV and I could go out and have as much unprotected sex as I like.

I think that I will now always be celebate alone and certainly now unemployable. Despite this I am content now and resigned. That is not to devalue the lives of those that battle through HIV, take their meds and can cope, but for me I am not a coper. What I would like to know is that if I am infected with a subtype that is not being picked up which is plausible given the fact that the town I live in is a hub for sub-saharan immigration, how long do I have based on my numbers.

I have spent four and a half years reading about HIV. I am not an imbecile despite my lack of grammer and spelling, in fact prior to this I was a double graduate, so I was fairly competent, but my reasoning and intellect have depleted over the years.

In short if this is an infection then how long roughly do I have to put up with this. Whilst I am content with the prospect of death, what does worry me is the possibility of blindness. So my second question is how many people with HIV suffer from CMV, and if so, how long from blindness to death. Sorry for the macabre tone of this post. I hope you can find the time to respond.

Cheers

LL from the UK.

Response from Dr. Frascino

Hello LL from the UK,

I'll be brief. Neither you nor Thomas from Germany has HIV. You have had multiple (excessive) ELISA tests out to two years plus an undetectable proviral DNA PCR. You just can't get any more HIV negative than that! I see no reason for following your CD4 cell counts (all of which are essentially normal, by the way).

You report: "I don't need psychological help." I strongly disagree. Comments like "I have given up on life and am happy about that . . ." and "I am not a coper" strongly reinforce my assessment that you are looney tunes and need a good shrink.

The bottom line is that you are HIV negative whether you choose to believe the overwhelming evidence or not. How you choose to live with that undeniable reality is totally up to you. I do hope you get the psychological/psychiatric help you need without further delay.

By the way, if your doctor really advised you that heterosexuals don't get HIV and you could go out and have as much unprotected sex as you like, it's definitely time to get a new doctor, because the one you have is a blithering idiot.

Dr. Bob



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