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3 month update (semi-WOOHOO) question
Dec 12, 2010

Doctor Bob:

Thanks greatly for your answer to my prior question (linked below). As an update, I have had several more negative HIV 1/2 AB tests, including 2 lab tests and the latest - a Uni-Gold HIV-1 rapid blood test at exactly 91 days. My partner in the unsafe incident also tested negative in a lab test at about 10 weeks but I've been unable to get her to test again. I've also come to find out she's been hiding a Percocet habit which makes me nervous in many ways including the potential impact on her immune system and that 10 week test.

So that's all great news, except that I still have all the symptoms I had before along with more pronounced shortness of breath and incidents of hands and legs going numb when elbows and knees are bent. Also my swollen neck glands continue. I did test positive for CMV infection but I'm finding it hard to believe that something that normally produces no symptoms in healthy people (which I was until 10 weeks ago!), and is supposed to be self-limiting, is at the root of this.

So, my question to you is,do I have closure on HIV or how can I get it? On the one hand, I have a neg DNA PCA at 7 weeks and scads of negative AB tests out to 13 weeks. On the other, I have symptoms that don't quit and if they're supposedly coming from a virus that doesn't really impact normally healthy people, and doesn't seem to be getting better, it makes me wonder if I'm in that .5% (or whatever it is) that don't produce AB within those 3 months. Please help (and I will be donating both for your help with me and the overall tremendously valuable service you're providing here).

http://www.thebody.com/Forums/AIDS/SafeSex/Archive/Infected/Q211927.html

Response from Dr. Frascino

Hi,

Welcome back to the forum.

Your "scads" of negative HIV-antibody tests out to 13 weeks plus your undetectable qualitative HIV PCR DNA are definitive, conclusive and WOO-HOO-able. Your partner's negative test at 10 weeks indicates you were not at significant risk for acquiring the virus. Her Percocet habit will not affect her immune system or the validity of her negative 10-week test.

I can't diagnose the cause of your symptoms over the Internet. However, what I can do with absolutely certainty is advise what's not causing them: it's not HIV. No way. No how. It's entirely possible your symptoms are anxiety related and will "magically" disappear once you accept the reality that you dodged the HIV bullet and are truly HIV negative.

Thanks for your tax-deductible donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated during this holiday season of giving. In return I'm sending you my good-luck/good-health karma that you are now and will forever be HIV free.

Happy Healthy Holidays.

Dr. Bob

HIV-2 and maybe other rare strains Nov 15, 2010

I had unprotected sex with a woman who claimed she was tested and HIV free (she never left the US, or the NC city she lives in for that matter). Afterwards I noticed an abrasion on my penis, so I would imagine this as a high risk as an exposure gets.

Since then my symptoms have been textbook ARS: swollen left cervical lymph node from day 20 on to now (day 60). Constant night sweats. Sporadic swelling of other nodes which subside quickly. Occasional joint pain.

I had negative Home Access at Day 28, negative HIV-1 AB and HIV-1 PCR at day 50, and negative HIV 1/2/O AB at Day 56. In theory with those results I'm close to WOOHOOland, but given the exposure and ongoing symptoms I'm petrified. I just ordered an HIV-2 PCR which will take 10 days.

Frankly I'm pretty convinced this will have a bad ending, but regardless I wanted to get your thoughts on this situation. Particularly troubling to me is that while all the literature you can read says HIV-2 is rare in the US there are virtually no current stats (although after countless hours of searching there was a recent blurb that New York City did a retrospective surveillance from 2000-2008 and found 62 confirmed or suspected HIV-2 diagnoses, 60 with West African ties. But I also saw another forum where someone claiming to be a nurse in San Francisco potsted that 10% of her new cases are HIV-2 now.

Would greatly appreciate any comment on my situation and the overall topic of risk when HIV-1 tests are negative.

And of course if my situation ends badly as I believe it will, I will send along the blow by blow to hopefully help others.

Response from Dr. Frascino

Hello,

No doubt unprotected sex is an unwise decision and places you at some degree of risk for STDs, including HIV.

Your "symptoms," despite what you read, are far from "textbook." Your repeatedly negative HIV tests out to day 56 are very encouraging, but not yet conclusive. For that you will need to wait until the three-month mark.

Even though you are "pretty convinced this will have a bad ending," I'm very convinced otherwise. HIV-2 testing was not warranted and the result will undoubtedly be negative. The information from "someone claiming to be a nurse in San Francisco" is pure poppycock. The retrospective surveillance data through 2008 is correct, as is the information linking HIV-2 very strongly to West Africa where HIV-2 is endemic. You can read more about HIV-2 in the archives of this forum, if you remain curious.

Good luck.

Dr. Bob



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