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The Worst Exposues and The Most Scary Telling Symtoms That Lasts Forever
Apr 10, 2009

Dr. Bob:

First of all, all repect to you. I wrote a couple of times before but I will make it quick this time. After a few possible exposures in late Dec. and early Jan. in China. I became sick after I came back and now I have had enlarged and painful lymph nodes all over my body, neck, armpits, groin areas for more than 2 months that have been confirmed by Doctors and ultrasound, they are not too large (not visible yet)but many, I have also had a low fever for for almost 2 and half months, ear temperature normal in the morning and night, reach 99.2,3,4,5 in late afternoon and early evening. I had all the other symptoms as well. I have done a whole bunch of tests, hiv 1/2 EIA several times, HIV1 RT-PCR RNA Quantative twice, by BDNA once, and most recently at 87 days post my last exposure I got HIV 1/0/2 and HIV1 DNA PCR Qualitative and all the tests done so far are negative. My CD4/CD8 ratio is low = 1.1 at 9 weeks and 80 days with my CD4% closer to the lower bound and CD8% closer to the higher bound. I know symptoms don't equal being hiv positive but generalized enlarged painful lymph nodes and persistly lower grade fever are probably the two most telling signs. I will spare you with the pain for my exposures except one I mostly worry about. I had electro-cauterization that vaporized some old bumpy scars from my nose in a hospital in China where things are different that they are here. I think the probe was not sufficiently sterlized and I know blood exposure is 100% infectous. It is unfortunate it happened but it already happened. Please comment on my situation. I have tried to recover emotionally to face the situation bravely recently but my fever and painful nodes remind me everyday something is seriously wrong with me. Do you think the window period will be longer for this type of blood exposure? It seems to me all the rare late seroconversions happened to situations like this. I think I will do PCR for HIV 2 as my next step and continue to test as long as my symptoms last. I will make a donation to your charity. Please reponse !!

Donation Made (Submitted Apr 9, 2009)

I am the guy just submitted a question called "worst exposures and most scary symptoms that last forever" and I just want to confirm that I just made a donation of a 100. I will donate more in the future if I have any money left after all the testing. Please answer my post when you have time. Have a good evening Doc !

Response from Dr. Frascino

Hello,

You are not HIV infected. Your repeatedly negative tests, including HIV-1/2, EIA, PCR RNA and DNA PCR out to 87 days are definitive and conclusive. HIV is not your problem. No way. No how. Your CD4 subset analysis is normal. (By the way there was absolutely no indication for you to have this test performed.) Negative HIV tests outside the window period trump "symptoms" each and every time.

Regarding your symptoms, a temperature elevation to 99.5 is not considered a significant fever. Your enlarged lymph nodes are not "visible;" consequently, they can't be very large. The lymphadenopathy associated with HIV disease is generally non-painful! There are literally thousands of illnesses that can cause enlarged lymph nodes. Why are you perseverating on HIV when you have overwhelming and irrefutable evidence that you are HIV negative?

Your assumption about blood exposure is also incorrect. HIV tainted blood, like some other bodily fluids from HIVers, is infectious but please note that not every exposure leads to HIV transmission! Even with significant occupational exposures, like mine in which I sustained a hollow-bore needlestick and laceration while performing a procedure on a patient with advanced-stage AIDS, the risk of HIV transmission was only 1 in 300.

Your fears are way out of proportion to any real degree of risk you experienced. Your symptoms may well be anxiety induced. I'd recommend you seek counseling to help you confront your irrational fears of HIV and also to help you accept the wonderful news that you are HIV negative.

Thank you for your donation to the Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated. Remember HIV is not your problem, OK? You should be WOO-HOOing, not worrying.

Be well. (You are indeed well.)

Dr. Bob



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