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Scared of what's to come........HELP!
Feb 3, 2011

Thank you for your time sir. I have run out of hope due to my symptoms and I feel as though I am infected. I dont know what to do and feel so alone. I am afraid for my children and my life. I apologize for the length of this post but I have to give you everything to hear what you think. Please help me! I have donated to your foundation through your website. You are an amazing accomplished man. I went to Manila in the Phillipeans 11/12-13 for a work trip. While I was there I had sexual relations with a sex worker. I met her in one of the establishments set up for that kind of thing. Supposedly the girls that work in these clubs have to go through weekly STD tests, but who knows if that is true. This is one of the biggest well known clubs in town. The first night I had protected sex with her. The one part that worries me is she took my penis into her mouth for not more than 30 seconds without a condom on, and there was no ejaculation on my part. Protected vaginal sex followed right after, and I am positive the condom did not break. I did kiss her deeply throughout the encounter. The next morning, the same thing. No oral sex. Just protected vaginal sex with deep kissing. Once again condom was intact. The next night I had the same girl. Protected sex, deep kissing, condom intact. She was grinding into me fairly hard pelvic area to pelvic area and was quite rough on my shaft, enough to where I was very sore in that area for a few days. Once I may have accidentally brushed the outside tip of my penis with the removal of the condom with the outside portion of the condom. I had diarrhea starting about 3 days after I returned from the trip. It was ongoing for 5 days then turned into almost constipation for a week. My doctor had a liver test done when I went to see him on 11/22/10 due to my trip to the Philippeans and my bad diarrhea and stomach abdomen pain. My readings were- ALT 44 AST 27 Which were normal but the incident that I was concerned with happened on 11/12/10 so it was fairly early still. After this I went on with life and had did not dwell on anything thinking I must of just had a stomach bug. I still had a little abdominal discomfort. On the 17th of December I had to have a blood draw from my employer for a biannual physical and I received a call from them because they were concerned with my liver readings which were- ALT-163 AST- 470 Also my LD reading was in the 700s and I had high protein and blood in my urine. Now I was freaking out. I went back my doctor and he did a full liver and hepatitis panel. The blood draw was on the 12/20/10 which was 39 days after the incident. Roughly 5.5 weeks after the incident. The results were- ALT 131 AST 80 He also did a Hepatitis panel and the results were- Hep A IgM, EIA Non-Reactive Non-Reactive- Hep B surface AG, EIA Non-Reactive Non-Reactive- HEPATITIS C VIRUS AB, EIA QL Non-Reactive Non-Reactive- Hep B core IgM, EIA Non-Reactive Non-Reactive- The next week (week 6) he did another CBC and liver function panel and the readings were about back to normal. During this time. Week 4 through week 7 my urine smelled, I had stomach pain around my belly button area and I was extremely tired. I felt like I was hit by a mack truck. I convinced my doctor to do a RNA Hep C test which came back negative. (I am immunized against Hep A and B). My doctor seemed to be fine with this and stated that I must of caught an unknown virus but everything seemed to be normalizing. Continuing on around week 7 I began to lose weight. I have lost 10 pounds. I developed a rash on my back which was in a small area on my back near my armpit consisting of a raised flat half inch lesion with smaller dots around it. I went to see my doctor again and he said it was too localized and in his opinion, and not an ars rash and was not suspicious. Week 8.5 I had an ELISA antibody test completed for HIV 1 and 2 which came back negative. Week 9.5 I had a PCR RNA HIV 1 test completed which also came back negative. This was done through Lab Corp. Around this time my mouth developed white patchy flaky loose skin on the inside of my cheeks for about 3 or 4 days. Then it settled into a white raised line that stretches across the entire length of the inside of both of my cheeks. My breath is bad and my mouth is still healed yet . I once again went to my doctor and he did a visual inspection and said in his opinion it was not thrush. I also had my dentist look and she said it was not thrush. My mouth has never done this in my whole life. I feel like what else can it be then? The doctor never did a culture of it. I feel that it is just a mild case therefore not alarming my doctor. It was only bad before I could get in into see the doctor. Also I forgot to mention that my stools and frequency of my stools have never returned to normal after my diarrhea. Week 10 through 11, my skin on my upper back is constantly feeling like it is burning and I have a few red pimple like raised lesions on my back in addition to the original rash that has never gone away. You can still see it albeit a little lighter. It doesnt itch but more burns. I have been woken up at night with my arms and hands going completely numb. I cannot gain my weight back and my appetite is better than it was. I notice now my arms seem to have a numbness even when I am awake sometimes now. I feel very weak. Doctor help me!! I am getting another HIV ELISA 1 and 2 test done in another week and I have never been more scared of anything in my life. My body has reacted since the incident with that woman and I have always been healthy my whole life. I know that my body is different, I can feel it. To top it all off after thinking about things that she had said, I believe that she probably was HIV positive. Question 1. Based on everything I have told you is there no hope for me? I am convinced that I am infected because my body is freaking out and I have never felt so physically messed up. Question 2. My doctor says that symptoms dont show up in a linear fashion like mine, but how else can all of my symptoms, high liver readings and everything else not be a complete totality of circumstances? Everything fits in the Acute ARS time frame, and my symptoms all from what I have read are all acute symptoms. Question 3. What do you make of my ELISA test at 8.5 and my RNA HIV1 test? Is there hope? It seems strange that the RNA test didnt pick up the virus. Could I be looking at HIV2? Question 4. I am afraid for my 7 year old daughter and 9 year old son. My daughter may have come in contact with small urine splatter (im sick thinking about it) on the toilet seat right after me and she has exzema and has open breaks in her skin on her hands and wrists. She uses her hands to get up on seat! She was upset and had her hands near her mouth and wiped her eye because she was crying because I had yelled at her for something. I noticed that she has had a quick bout of diarrhea, sore throat, and lymph node swelling recently. My boy had swollen lymph nodes as well. I know that there has been some sickness at their school and in my neighborhood but I cant shake the feeling that I may have done this! Plus I put Neosporin on her wrists sometimes and before I realized that I may have been sick we were sharing the same tube of Neosporin that I was using to treat a a weird dry breakage in my skin on my finger (no blood). I am freaking out!!!!!!!!! Are they at risk Doctor? Thank you for your time I dont know how I can find the strength and will to get through this. I feel as though I may have ruined my families lives forever. My joy and zest for life has been extinguished..help meplease!

Response from Dr. Frascino

Hello,

Feeling as though you are HIV infected and actually being HIV infected are two completely different things! Your HIV-acquisition risk (30 seconds of unprotected insertive oral and several bouts of protected vaginal sex) is negligible, assuming the latex condoms were used properly and didn't fail (break). Although over the Internet I cannot diagnose the exact cause of your transient elevation in your liver transaminases and the blood in your urine, I can advise you these are not common symptoms associated with HIV acute retroviral syndrome (ARS).

Your negative 8.5-week ELISA and undetectable HIV PCR RNA at 9.5 weeks are extremely encouraging. I very strongly anticipate your definitive HIV-antibody test at three months will also be negative.

Regarding your specific questions:

1. On the contrary, I think there is every hope for you! I don't think your body is freaking out nearly as much as your mind! ("I have never been more scared of anything in my life.") You are basically "worried sick!" (Your anxiety is making you ill and that's why you feel "so physically messed up.")

2. As both I and your doctor have advised, your symptoms and the timeline are not consistent with HIV. You may feel "everything fits in the acute ARS time frame," but in reality that just isn't the case.

3. Not only is there hope, but I have every confidence that you are HIV negative. There really isn't anything at all strange about your undetectable HIV PCR RNA at 9.5 weeks, considering your negligible HIV-acquisition risk! In fact we would have anticipated it would be undetectable. As for HIV-2, it is endemic in West Africa; you were in the Philippines!

4. Your fears regarding your daughter and son are completely unwarranted and quite irrational. They again suggest you are suffering from anxiety, guilt, depression and completely irrational fears about HIV. ("My joy and zest for life has been extinguished. . . .") I would advise you seek psychotherapy (counseling) to help you confront your irrational HIV fears. You may also need help managing your depression and anxiety.

Good luck.

Dr. Bob



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