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You are the only one who can help me ! HIV scare

May 19, 2014

Dear Doctor, I believe that you are the only one who can help me i sent you before, but i have some updates for my case. I am a male ,29 years old , From Egypt where the population is 90,000,000 , and only 3,000 HIV cases ( in my country even famous doctors don't know a lot about HIV ) My risk was : unprotected vaginal sex with sex worker for 1 time at Dubai with ejaculation inside end of November 2013 . I called the girl asked her if she have HIV she answered that she isn't but when I asked her if she tested before , she told me that she never tested before for HIV. (i can't believe that she isn't an HIV case) Symptoms: After 4 weeks :i had a Sore throat for 8 days, after 7 weeks : mild night sweat every night , loss appetite , loss weight till now( 9 kg about 10 % of my all weight). After 10 weeks : a flue for only 3 days with a fever of 38 after 12 weeks : diarrhea for no reasons (9 days and then went for 3 days and came back for 3 days) and 3 small red dots in each hand for 2 weeks. Tests did with result : ( I went to lab near to my home ,I don't know if they use ELIZA technology regarding the HIV tests or not and for sure not the 4th generation tests ... i am trying with the nurse to know the name of the test she don't know and i also tried with customer services they don't know . all they tell me : HIV antibody (aides test) How in 2014 a big lab in the middle East they don't know the test name The lab customer services told me also they use ELISA for virus C & B. In this lab they take a blood sample from my arm in the morning and I receive the result same day at afternoon . Can you suggest which test is that ??

11 weeks : Hiv antibody ( non reactive 0.12) 82 days : HIV antibody ( non reactive 0.11) 85 days : HIV antibody ( non reactive 0.24) 90 days : HIV antibody ( non reactive ) 94 days : HIV antibody ( non reactive ) at 3 months :I decided to go to a doctor (not HIV doctor as in my country it is very difficult to meet HIV doctor ),to check o myself to know what is the cause of my symptoms, he asked me to do some tests : RPR : Negative VDRL: Negative Herpes simplex virus type 1 Igm : Negative Herpes simplex virus type 1 IgG: POSITIVE Herpes simplex virus type 1 Igm : Negative Herpes simplex virus type 1 IgG: Negative Hepatitis B surface antigen : Negative Hepatitis C virus antibody (3rd generation) : Negative Urine analysis : Normal Stool Examination : Normal SGPT (ALT) : 16 ( normal range ) SGOT (AST) : 12 ( normal range ) TSH : 1.09 ( normal range ) ESR: first hour 8 , second hour 20 Fasting plasma Glucose : 95 ( normal range ) Glycosylated Haemoglobin ( HbA1c ): 5.4 ( normal range ) LDH : 143 ( normal range ) C-reactive Protein (CRP) titre : 0.6 ( normal range ) Complete blood picture : Hemoglobin: 14.9 Haematocrit(pcv) 42.5 RBCs count 5.47 MCV : L 77.7 MCH : 27.2 MCHC : 35.1 RDW-CV: 12.0 PLAtelet count : 370 Total LEUCOCYTIC COunt : 4.3 Differential leucocytic count: Neutrophils: 35.7 % 1.69 Lymphocytes : 48.1 % 2.28 Monocytes : 10.1 % 0.48 Eosinophils : 5.7% 0.27 Basophils: 0.4% 0.02 **** ( comment: RBCs show mild microcytosis .Relative LYmphocytosis. Relative Monocytosis. Absolute Neutropenia) Te doctor told me that i am fine and my symptoms may be related to ANXIETY or any kind of bacteria, and i turned off this page and removed it from head. But after another 5 weeks ( after 4 month from my risk ) I started to feel another symptoms and I still have them all till now : 1-Mild Sore throat , never went till now 2-I feel pain in my neck , 3- Rash in my front head, never went till now 4-swollen lymph nodes around my neck and my mouth i went to another doctor who ask me for the following tests and CT for neck and chest: Epstain barr virus antibody toviral capsid antigen ( VCA-IgM ) : negative ANA by Elisa : Negative Serum calcium : 9.7 ( normal range ) Serum LDH : L 116 C-reactive Protein ( Quantitative ) : 0.3 ( normal range ) Complete blood Picture : Normal blood picture ESR: first hour 8 , second hour 18 TSH: 1.20 ( normal range ) Free T3 : 3.1 ( normal range ) Free T4 : 1.4 ( normal range ) Chest CT comment : Normal CT scan of the chest. Neck CT comment : MULTIPLE BILATERAL MILDY ENLARGED UPPER AND LOWER DEEP CERVICAL LYMPH NODES , THE LARGEST NOT EXCEEDING 1.8 CM IN ITS MAXIMUM DIAMETER. NO MATRIX CALCIFICATIONS OR AREAS OF BREAKING DOWN. When I went back to the doctor he told me that I am very good but he gave me antibiotic for 5 days I finished the antibiotic from 3 weeks and without any progress Swollen lymph nodes, Sore throat, the rash in my front head, for almost 1 month and half 2 small ulcers in my tongue + very dry lips from 3 days I found another lab where they have HIV ag/ab test by CMIA but they asking for full details and a copy from the ID. I went there once and I will not go again as if I tested positive they will report the result for the ministry of health , and they will but me in an HIV Hospital for rest of my live. I did there the test : At 18 weeks from my risk: Hiv Ag/Ab. by CMIA : Negative at 21 weeks : HIV antibody ( non reactive ) ( in the first lab) week 23 : HIV antibody ( Non reactive) ( in the first lab) My question : 1.does my symptoms at 4 months from my risk is related to HIV ? Can HIV symptoms appear under any condition after 4 months and half from the risk action ? Are HIV symptoms related to when the virus entered the body or when the body is starting fighting the virus ? 2.Should i retest again until 26 weeks ? 3.if they are related when I will test positive after them ? 4.Does my lymph nodes , the sore throat, and ulcers in my tongue mean that my body is trying to produce antibodies ? as the doctors didn't find a reasons regarding them. 5.Do you think that I am an HIV? and i need more tests ? I know that in 3 months window period is conclusive but i found a lot of cases which tested positive after the 3 months here on this website which make me confused . and i have an inside feeling telling me that I am infected and there is something wrong with my lab result, I feel myself not normal. And no one can tell me my symptoms reasons Please keep in mind that before this situation I never went to a doctor or did any blood test and was rarely get sick. Sorry for my long question I tried to explain each details as much as I can, but please have a look for all my case , and try to response to my question in details as much as u can ,as I need a bottom line for this situation ,and I need to get back to my normal life Please I NEED your HELP , there is no one in my country that I can ASK him or talk to him. Thank you,

Response from Dr. Wohl

I think your repeated and extensive testing shows you are not HIV infected. There are many causes of small lymph node enlargement besides HIV. I would not repeat any HIV related testing.

DW



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