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according to ur experience what can i do realy scare??
Aug 7, 2009

hello dr. BOB plese may u answer me on my contry there is no any dr familier with hiv also i asked u 2 time before and u didn't answer i chcked all the profile i didn't find anyquestion near to my situation

i developed series symptoms after receiving oral sex (serious lips kancer sores from lips insaide the uper and lower lips(came after 2 weeks and stay 2 months), OHL with whait tongue(stay 4 months until now didn't go even i get tretment by antifangi becouse my dr thought it is throush but i know it OHL becous it didn't go and my tongue has white patches and hairy) and penis discharge also came after 1 week and still 3 months also a got antibiotic and didn't go), back bain,Constipation

i tested for chlamydia syphilis gonorrhea all NEG i have gote hiv test at 3,6,9,13 weeks both (antibody 3rd gen) and (4th gen combo antibody antigen)all NEG also RNA PCR at 13 weeks came <20 undeteted

my questions

1-is it possible to be inficted by HIV and after 3 months the viral loud RNA become undetectd?? becuse i read that viral load is high only on the first 3 weeks??

2-is the RNA test sensitive only on the early 4 weeks to ?OR it will be positive after infection and stay positive for ever if the person didn't take tretment? becouse i read some people ther body can fight and control the virous which remane undetected?

3-because they said dont use the PCR except during the first 4 weeks is this mean that the RNA viral loud will declain down to not detected after several weeks?

4-what about antibody and RNA after 3 mouth all NEG is this mean that absolutely there are no infection regardless to any symptoms??

5-according to ur experience do u think i have to retest after 6 months? and can i have unprotected sex with my wife or there are chance to be inficted?

6- all this symptoms do u think it related to HIV? if no what can couse all this if i tested NEG for all STD?

Response from Dr. Frascino

Hi,

In your country there are no doctors familiar with HIV???? What? Where the hell do you live? Dumb-as-crapistan?? Oh never mind; let's move on to your problem. You report you couldn't find any questions similar to yours in the archives??? Hmm . . . I tend to doubt that, unless your problem involves sex with a cross-dressing Mormon wombat and involves a trapeze and a hairy man named Bruno who has webbed toes. So let's see, you're concerned about "symptoms after receiving oral sex." WOW!!! And you think no one has ever asked about that before??? On rough count there are a gazillion and one posts in the archives with similar concerns. Really! Count them!

OK, so you had some canker sores and what you self-diagnosed as OHL. Interestingly your doctor diagnosed your mouth problem as thrush, but you didn't bother to get treatment with antifungal medication as prescribed because you "knew" it was OHL. Hmm . . . now remind me again which medical school you graduated from that gives you the knowledge and authority to ignore your doctor's diagnosis! Not surprisingly you've had excessive and unwarranted HIV-antibody testing, all of which has been negative out to 13 weeks. In addition you've had a negative HIV plasma RNA PCR viral load that was undetectable at 13 weeks. This test was unwarranted a well. And here you are writing to me because you remain "really scared" about HIV. So to sum up you had an extremely low-risk exposure (oral sex) followed by "symptoms" and an excessive and unwarranted amount of HIV testing, all of which has been negative. And this scenario doesn't sound familiar to you after reading the archives??? Really??? Hmm . . . I'd suggest you reread the archives. And this time pay attention! There are countless archival posts with very similar histories. My assessment and advice always remains the same:

1. Oral sex is low risk.

2. Symptoms are unreliable.

3. Don't self-diagnose.

4. A negative HIV-antibody test outside the window period trumps symptoms each and every time.

5. Your worries are unwarranted and irrational.

Briefly responding to your specific questions:

1. No.

2. No.

3. PCR is not recommended for routine HIV screening. RNA viral load remains elevated in untreated patients.

4. Yes.

5. No. I do, however, suggest you level with your wife. It's the right thing to do.

6. No, of course not. I cannot diagnose the cause of symptoms over the Internet, but I can advise you HIV is not the cause!

Dr. Bob



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