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Dr. Conway - "rare cases" expert - PLEASE help me! (no response from "Safe sex " forum)
Aug 20, 2007

Dear Dr. Conway,

Firstly, thank you for this web side it helps me a lot during this hard time. Sorry for my English, but I am not native speaker (I am from Hungary).

My case is quite complicated. April 20: relatively low risk exposure mutual masturbation and French kissing with gay of unknown status (but I think we was positive, as he behaved in strange way: didn't want to continue French kissing after some time, and was suspiciously careful). The problem is that after the action I had lots of his sperm on my hand, so I took tissue, cleaned it and then cleaned also my penis (including the glans). I don't remember if I did it with the same tissue or not. I also immediately took a shower and touched my penis with hands. OK, still low risk but what happened then put me to the limits of what I am able to experience (both physically and mentally). The list is long and horrifying: 1st week: itching of my glans (about two days), diarrhea (occasionally). 2nd week: two WHITE PATCHES INSIDE OF MY CHEEKS (I have it till now, to some extent it can be wiped away but not all), non typical sore throat (for the next month). After 3rd week starts the worst (I assume ARD ): at night I woke up with fever (I didnt have thermometer, but I just felt that I was hot- lasted about one week) and in the morning I SPIT BLOOD (also in the next following two days but only in the morning), night sweets, painful arms (joints and muscles), weakness, some kind of mild dementia, loss of appetite, weight loss (could be because of stress, later I gained some kilograms), swollen and painfully lymph nodes, bigger veins on hands, rash on hands (but I rather didnt have fever at the same time time, small spots on right forearm, erythema on left arm), some kind of overflowing in abdomen, very painful calves (even at night, despite the fact that I took magnesium), little fingers numbness at night. My skin was not elastic and it became red for a long time when I touched it harder. During this time I drank frequently because I couldn't sleep.

It stops in week 6-7. Then I had chest pain, night sweats again and some difficulties in breathing (maybe it was because of incredible level of chronic stress that I had from week 3) . I didn't go to doctor with all of that, because I was abroad all this time (Austria) so was not willing to do this and sure that it is HIV (I just had silly thoughts: that the end even doctor wont help you)

When I came back home I took at once Western Blott (know that its not good testing strategy, but I was sure) after 9 weeks. NEGATIVE ! I couldn't believe it. I took HIV 1/2 COMBO (Ag/Ab) after 10 weeks. Negative. I still felt week and slept lots of time. Sometimes at night I had hands numbness what waked me up. I took ELISA III after 13 weeks. Negative. Always after taking the blood for the test I have to wait really long (about 5 minutes) till the blood will stop to pour blood coagulability problems? have never had it before!

Now I have sometimes painful, a little beat "disappearing" gums , still that white patches inside of my cheeks and my big toe is a little bit red and painful (infection?) - never had it before, stomach-ache, PAIN IN ANKLES, loss of appetite. There is rather no reason for late seroconversion (negative RNA HCV after 3 months, no PEP, no drugs, no chemotherapy, vaccinated for hepatitis-B, always rather strong immune system).

So what is going on ?! I know: [(French kissing + mutual masturbation) times (negative ELISA after 13 weeks)] = probability of being infected close to zero. But statistics is statistics and life is life. ALL symptoms indicate that it is HIV. I know that some of them can occur because of high level of permanent stress, but some just cant !

What should I do: PCR RNA, PCR DNA, ELISA after 6 months? Finally go with that white patches in the mouth and possible nail infection to dermatologist? What do you think about that spitting of blood in the three mornings of week 3. Is there connection with HIV? Maybe it is some rare strain, difficult to detect? If not HIV than what? What other tests should I perform. Maybe it is other STD. I think about PCR, but I am afraid of false positive, and the fact that my status anyway will not be confirmed and I will not stand it mentally. I feel like being in a trap. PLEASE help me Dr. Conway!

Kind regards. Worried well

Response from Dr. Conway

I think you need to believe the results of your HIV tests and move on. The one and only other test I would do is a CD4 count, to make sure that we are not missing one of the extremely rare cases that could be missed by the excellent HIV tests you have already done. If the CD4 count and the CD4/CD8 ratio are normal, I would FOR SURE move on from the possible diagnosis of HIV infection here.

PCR test
teabag follow-up...

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