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Dr. Bob Please help (desperate) Will make donation next week
Dec 22, 2010

Dr.Bob, I was exposed to HIV unprotected oral sex from a women on Nov.8,2010 who it turns out is HIV positive and have been having the following symptoms for almost six weeks now. Sore feeling on roof of mouth,weight loss 27 lbs.,loss of appetite ,almost constant mild headache's, stomach noise, tingling in right hand and fingers and discomfort in my groin,head,neck and arm lymph nodes as well as ear pain and feeling cold in my stomach and chest. Also I received PEP 72 hours after exposure(Truvada) and took it for 28 days and had a pcr-dna and blood test done at 30 days after exposure both were negative.

My questions are: 1. Do my symptoms sound like acute infection symptoms from your experience. 2. If my symptoms are due to HIV acute infection then do you think The pcr-dna test would have been positive at the 30 day mark even though I was still on pep. 3. What testing would you recommend besides the normal antibody testing I will be doing at the 3 and 6 month marks.

I have a wonderful wife and several kids and I am very worried,I have not sleep with my wife since this happened and been to my doctor several times however he does not have a lot of experience in this field. Thank you and Happy holidays Dr Bob I will make a donation next week after I receive my next check

Response from Dr. Frascino

Hello,

1. Symptoms are notoriously unreliable in predicting who is and is not HIV infected. The risk of acquiring HIV from oral sex is very low.

2. HIV PCR DNA testing is not FDA-approved for HIV-diagnostic testing.

3. The guidelines for post-PEP diagnostic testing is HIV-antibody testing at four to six weeks, three months and six months from the date of exposure.

Although your HIV-acquisition risk is very low, and I strongly doubt HIV is your problem, I am concerned about a 27-pound weight loss over a relatively short period of time. I'm not concerned this is HIV related. But that degree of unexplained weight loss does warrant an evaluation for other medical conditions.

I would advise:

1. Level with your wife, if you haven't already done so. It's not only the best way to confront your guilt and worry; it's also the right thing to do. Use latex condoms with your wife until your negative HIV status can be reconfirmed.

2. Follow-up with your doctor for post-PEP HIV testing and for evaluation of your weight loss.

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

Good luck.

Dr. Bob



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