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Follow up to "expert opinion needed"
Feb 22, 2010

Hi Dr. Bob,

Thank you for the reply on my last post. Its been 12 weeks since my last possible exposure (massage with manual stimulation). Ever since the massage I haven't been feeling well RUQ discomfort, blood shot eyes, Pinguecula's that seemed to appear overnight, ultrasound revealed a thickened GB wall etc... I am taking your advice and setting up an appointment with an intensivist to get to the bottom of my problem. However, I would like to close this door before I move on and that is why i am seeking your expert advice again with my updated testing.

I have had the following tests 8 weeks: HIV DNA PCR: neg HIV ab w/ ICMA: neg Hep C RNA: neg Hep a/b/c ab: neg 12 weeks: repeated same tests including all PCR's with negative results.

1. According to the testing timeframe do you think further testing is warranted? 2. As far as Co-infections (unlikely but curious), wouldn't the combinations of tests have detected something at this point? 3. If I did potentially acquire a type of hepatitis would you consider testing out further?

I really appreciate your help on this matter. Your website and comments have given me comfort over the past 3 months. This is a great service to humanity. Best of luck, Johnny.

Response from Dr. Frascino

Hi Johnny,

1. No.

2. Yes.

3. You didn't acquire viral hepatitis; therefore, this question is moot!

Johnny, my assessment and advice have not changed form my initial response (see below). Your HIV risk is nonexistent. Your symptoms are not consistent with HIV ARS. Your negative HIV-antibody tests and undetectable PCRs are definitive, conclusive, excessive and WOO-HOO-able.

I recommend you see an "internist" (internal medicine doctor), not an "intensivist" (intensive care physician).

Good luck. Stop worrying about HIV!

Dr. Bob

I need your expert opinion, please!!! Jan 30, 2010

Hello doc, I've spent numerous hours on this website reading various posts. The work you are doing here is outstanding and a great service to society. How can I donate via CC to your foundation? Approximately 2.5 months ago, I recieved an erotic massage with no penetrative sex, kissing, etc. (only manual stimulation). A couple of days after the incident, I developed bronchitis and liver tenderness which persists even today (10 weeks later).

Testing history: After 8 weeks of the liver tenderness, I got myself to the lab and received an acute hepatitis panel and other std's testing which was negative. At 9 weeks post, I took an HIV DNA PCR with an antibody test and a HCV RNA PCR test all negative. 10 weeks post incident, I took an instigold hiv test (finger prick) and tested negative.

Even though the massage was low risk for acquiring HIV, I believe I might have picked up some extra luggage. All I know is prior to the massage I was feeling wonderful, then after the massage--not so wonderful. The liver tenderness is quite constant. I also tested for ebv, lft's, cbc's, and had an ultrasound-- all normal. I was hoping for a dysfunctional gallbladder, but that didn't happen. It would have at least given me closure. Does this sound like an hiv concern? Can I rule out HIV infection with my current tests to date? I figured that the pcr's would be a good indicator of status since they came back negative. Thank you for your time! Take care.

Sincerely, Johnny

Response from Dr. Frascino

Hello Johnny,

A rub-and-tug (massage with happy ending) is not considered an HIV risk.

Symptoms that begin "a couple days" after a potential HIV exposure would not be related to HIV transmission. The symptoms associated with acute retroviral syndrome (ARS) generally become manifest two to three weeks (not days) after primary HIV infection.

Your undetectable qualitative HIV DNA PCR, undetectable quantitative HIV RNA PCR and negative HIV-antibody tests out to 10 weeks merely corroborate what we already knew: Your symptoms are not HIV related.

Unfortunately I cannot diagnose the cause of your liver tenderness. But what I can do is advise you that HIV is not the cause. I'd suggest you follow up with an internist (internal medicine physician) for further evaluation. Just remember, HIV is not your problem. No way. No how. OK?

Donation information, including credit card information, for the The Robert James Frascino AIDS Foundation is available on the foundation's Web site at (www.concertedeffort.org). Thank you for your tax-deductible gift!

Be well!

Dr. Bob



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