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Not a Question of Worried Well

Jan 13, 2013

Dear Dr. Wohl, I had multiple unprotected exposures with around 15 girls in the last 8 years (rough estimation). I didn't know their HIV status. Most of them I just had 1, 2, or several casual sexual encounters, and 3 of them I developed a few months' relationships. My last unprotected exposure was on mid-August 2012. I became aware of my HIV status since late-September 2012. With severe upper abdominal pain radiated to the back, I was diagnosed with chronic gastritis and esophagitis on 19 Sept 2012. After that, I have been developing weird neural pain (tingling, numbness, burning) on my upper back and chest, and it is persistent and worsening until now. I had a whole body PET scan to rule out malignancy on last Oct. And then every symptom coming up are pointing to HIV/ AIDS. I have white coated tongue with tingling feeling. I have persistent night sweats. And I become aware of my numerous raised warts on my shoulder, trunk, and abdomen which I firstly supposed to be caused by continuous sun light over the years. I have a bean-shaped lymph node under my left mandible. However, I don't have fever and obvious weight loss, and my appetite is normally good. Then I have multiple Duo combo and PCR RNA tests, and all the results are negative. Is it absolutely conclusive if I had negative Duo combo plus PCR RNA after 3 to 4 months of my last exposure? Due to my multiple risky exposures in the past years, I'm worried of complicating the disease's diagnosis and/or progression and the possibilities of developing rare/virulent/recombinant/superinfected/rapid progressing viruses or other unusual circumstances (e.g. highly exposed seronegative) that the antibodies and viruses are not detected by the tests. Is there anything I can do to completely rule out HIV infection? Is that viral replication can be restricted in only mucosal tissues or lymphatic system, but not necessarily in the blood plasma? Apart from the tests of the plasma, is having biopsy possible to rule out highly suspected but seronegative cases?

Thanks, Chan

Response from Dr. Wohl

Why not get a CD4 cell count? You have had so many tests and evaluations done but this simple test will reveal all. If your CD4 cell count is normal, there is no way you have HIV as the cause of your symptoms as it is reduced immunity that leads to the opportunistic conditions you fear.


high risk exposure
Receptive Anal without protection for less than 30 seconds? RisK?

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