One More Question please
May 23, 2010
Dr Bob I will try to make this short. I wrote to you before.(Last hope--- PLEASE LOOK & re; last hope please look)I took your advice and went to psychologist, he told me to read your answer when I was worried and I do. I was going to a neurologist for the numbness I get in my hands every night I sleep. She only found a low side, normal thyroid. I had MRI and all. She did a CD4 at my request.(sorry) she told me all my tests were normal. I am going to a new internist on Monday to try to get to the bottom of this numbness that is plagueing me. My tongue looks like OHL although every Dr and my Dentist dismiss it. I now have red spots appearing on my lower legs. My wife now has a rash on her body that itches. My wife, children and I have been having diareah. Is it impossible for me to have hiv with all the tests I have had. What should I tell the new internist. Please help me one last time. Thank you, desperate
Response from Dr. Frascino
Welcome back to the forum. Sorry to read that you are still being plagued with the same irrational fears and totally unwarranted worries about being HIV infected.
Is it possible for you to have HIV despite your greater than 20 negative tests and normal CD4 count over 17 years? Absolutely not.
What should you tell the new internist? I would suggest you bring a copy of your three posts to me and my responses. (I'll repost them below.) I would urge you to see a psychiatrist to help you confront and conquer your irrational fears.
Last hope --- PLEASE LOOK Dec 10, 2009
Dear Dr Bob,
17 years ago (1992) I had a possible unprotected exposure to hiv with a female vaginally(a couple of times). I had terrible pharingitis, night sweats,etc shortly after that. 5 years later I was engaged to a different girl and she had a body rash, joint pains, etc. She went to an ID doc who told her she should be tested for HIV after he tested her for Lymes. We had both just done Home Access so we thought we were fine. To make a long story short we married and now have two children 7 and 10. In the ensuing years I have had many tests; 2more home access, 3 different life insurance pol's, and a Elisa blood draw from doctor. I went to ID doc myself in 2001 because of some weird symptoms( wife had cervical dysplasia, and we both got molluscum at different times in our groin area, and my tongue has white lines down both sides) He said I was fine and that the lines on tongue were nothing to worry about. He did a hiv-1 test (negative) and said forget about HIV. I felt stupid and was very happy. I decided since I was negative that I should do something good and donate blood. ID doc said it was fine. since 2001 I have donated 11 times till this past Feb. ( I felt great! ) Now in July I got diarreah on and off for 2 months, went to see gastro guy who did tests( all ok ) including labcorp ICMA hiv 1/O/2 test (nonreactive) which I asked for. Now my hands keep going numb at night. Kids constantly have runny noses. Please don't get angry with me for the question. Any doctor who I have asked thinks I am nuts. I have had 20 tests in the last 17 years including life ins, and Nat with blood donations, not to mention that both kids were tested when they were born along with my wife ( pregnancies and life ins ). Is all I need really a good psychiatrist. Please advise 100 dollar donation is forthcoming.
Response from Dr. Frascino
Why would I get angry? I'm not an angry kind of guy. Your repeatedly negative HIV tests (20 over the past 17 years) are definitive, conclusive, excessive and absolutely WOO-HOO-able. Unfortunately, despite overwhelming and irrefutable evidence that you are unequivocally HIV negative, you're still not WOO-HOO-ing and you continue to freak out when even any type of health problem arises in you, your wife or your kids. There can be no doubt your fears are totally unwarranted and completely irrational. Your problem is not HIV, but rather fear of HIV. Psychotherapy (counseling) and/or medications could indeed be quite beneficial in helping you confront and conquer these irrational worries. No additional HIV testing is warranted. HIV is not your problem, but you do indeed have a problem that warrants attention. Bring a copy of your question and my response to your first visit with your therapist and show it to him or her. It will help focus your treatment and speed your recovery. Be well. Stay well. I wish you happy, healthy, worry-free holidays.
re; last hope ---- please look Jan 5, 2010
Thank you so much for your answer. Donation of $100 has been made to your great organization. One last thing if you don't mind. 1. When someone had a real exposure and real symptoms and or signs pointing towards hiv is the antibody test that reliable that you would rely on that alone? 2. Would you or have you ever recommended pcr or cd4 cd8 test after a negative antibody test outside of the window period? 3.Is it really no way no how? Thank you and God Bless
Response from Dr. Frascino
Even if someone has a "real exposure" and experiences "real symptoms and/or signs pointing toward HIV," if they test HIV-antibody negative outside the window period without extenuating circumstances, they are HIV negative. A negative HIV antibody test properly conducted outside the window period trumps "symptoms" each and every time. CD4 and CD8 T-cell subset tests are not diagnostic tests for HIV. Changes in CD4 cell counts are not specific for HIV disease. They can change as a result of other diseases as well. They are, of course, very useful in monitoring the clinical course of a person confirmed to be HIV infected. PCR testing is not generally recommended for routine HIV screening, due to the rate of false positives, other technical considerations and cost. I have used PCR tests diagnostically only when indicated: for instance, in some folks with impaired ability to make specific immunoglobulins (agammaglobulinemia, common variable immunodeficiency, etc., or to diagnose acute retroviral syndrome within the window period, etc.). You can read much more about HIV diagnostic and HIV monitoring tests in the archives of this forum. Thank you for your donation to The Robert James Frascino AIDS Foundation. It's warmly appreciated. The bottom line is that an appropriately conducted HIV-antibody test can indeed give a "no way, no how" result!
Be well. Stop worrying.
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