Nov 25, 2009
Dr. Bob- I am terrified due to the following symptoms 7 months after possible exposure. ARS type symptoms within 2 weeks; over the past 7 months: multiple oral sores, hairy tongue, angular cheilitis, folliculitis, nose bleeds, cold sores, fatigue, loose stools. Over the past 2 weeks I have developed a stiff neck along with a serious sinus head cold that will not go away. Worst of all I went to the hiv dr due to what I thought was thrush and he confirmed it!!!!
I know you will say this test wasn't necessary but I (you may recall this from an earlier email) had cd4/cd8 done 3 times over 3 months; went form 960 - 820 - 660!!! Yes they are within normal range but are dropping and now I have thrush!!!
The facts are that I had a possible exposure, had the mentioned symptoms (all pointing to hiv, especially the thrush) and have had hiv 1/o/2 negative tests out to 6.5 months.
The hiv dr recommended that I continue to test in another 3 and 6 months?
The exposure could have put me at risk for rare types. If rare types are not picked up by AB tests after 7 months, does that mean that they will never show up on AB tests? If infected, how would you find the virus?
If you had a strong suspicion, based on your evaluation of the case, that one of your patients was infected but not showing pos on ab test past 6 months, what course of action would you take/recommend?
What should my next step be? I really need your help/guidence/recommendation/support, I don't know what to do...
Thank you...and please reply...
PS- Enjoy your turkey!!!
Response from Dr. Frascino
If you've had repeatedly negative HIV-1/O/2 tests out to 6.5 months, I would conclude HIV is not the cause of your symptoms and search for other potential causes. Please note, the vast majority of cases of thrush have absolutely nothing to do with HIV.
You are correct: Getting CD4 counts was not warranted. You are also correct that all three of your CD4 count determinations are completely normal. That there was a decline within the normal range is not significant, nor is it suggestive of an immunodeficiency-related problem. Normal is normal!
There is now overwhelming and irrefutable evidence that you are HIV negative. I would advise you stop chasing a disease that you could not possibly have. If your current doctor is unable to help with your current symptoms, I'd suggest you get a second opinion. One thing is certain: HIV is not the cause of your problems.
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