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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Aug 15, 2005

Dear Dr. Conway, I have a very puzzling situation, I hope you can guide me in the right direction. I had a possible exposure 34 months ago. The symptoms that followed were quite similar to seroconversion symptoms-sore throat, fatigue, possibly a rash. In the past few months I have developed joint pain/muscle pain, eczema( hands, feet,ears, and genitals), folliculitis, and a condition known as post inflammatory hyperpigmentation (on my arms, back, face, and stomach). I never worried about HIV until my doctor mentioned a test after she noticed my eczema (Don't ask, I still cant figure out the reason she did this) Last year, I went from 202lbs to 160lbs after some sort of stomach infection(lost my apetite). I had an ear infection, h pylori, and diarrhea for quite some time now. The tests I have taken are the commerical ones-2 elisa, 1 Western blot, 3 Oraquick, 1 HIV-1 DNA PCR, 1 HIV-2 DNA PCR, and 1 RNA PCR. I also asked my doctors to run a CD4 count. The first cd4 was 856(45%) cd8 342(19%) ratio-2.5 The second test was a month later cd4 853(50%) cd8 324(18%) ratio 2.5. Despite these numbers my symptoms are still persisting. The only thing that I have noticed is that my WBC count is low in the morning at around 3.6 and is at 8.0 at night, and my igm is low. As you can see my situation is puzzling because the numbers indicate one thing and the symptoms(which I have to deal with) indicates something is going on. I was really hoping that you would be able to direct me with your advice. I've called a few labs but the reverse transcriptase test is for research only, my doctor doesn't know how to ask for direct sequencing. What is your advice? Which test can ultimately, definitively, conclusively rule out hiv-I thought it would be the reverse transcripase-but how would I even be able to ask for it?

Thanks for everything, I can't wait to hear from you.

Response from Dr. Conway

My advice is: FORGET ABOUT HIV...

I am sure that your symptoms are real, and I hope you do find a cause for them. My strong suspicion is that your doctor couldn't figure out what was wrong with you (a situation I find myself in, all too often, I fear...) and she was "grasping at straws. HIV was legitimately considered, and has now been ruled out. Forget it. Move on...

There are a number of chronic infections, immunologic conditions and others that could explain your symptoms...I hope you find the smartest specialist in your area and that she (or perhaps he) is able to help you out...

Open wounds and mucous membranes

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