Can I get HIV from sharing a can of beer with a tranvestite?

Question

OK, Dr. Bob,

I'll admit it - I never shared a can of beer with a transvestite. But I HAD to do something to get your attention, even if the headline had you poised to strike down someone so ill informed about HIV transmission!

I sincerely apologize for the ruse, but you get thousands of e mails,so I needed to find a way to get your attention. But, I very seriously do need your advice, though: I had a serious HIV exposure to a man from Latin America 1 1/2years ago, who was very ill at the time. A week later, I developed the worst prostatitis and a range of unbelievably bad viral like symptoms. But, had negative ELISA tests at 3, 6 and 12 months plus negative bDNA at 3 months and a negative Roche 1.5 at 12 months. The guy from Latin America denied having HIV and then disappeared on me!

My T cells bopped down by hundreds of cells and my CD8's were very elevated for most of that year and I was intensely ill. Now it is 1 1/2years later and I am still unbelievably ill...I had HIV-1 and HIV-2 antibody tests again at 14 months, yet everything about this illness feels and seems so viral (even had reactive lymphocytes on a blood smear 14 months after the exposure).

My question is this: I am REALLY ill with a wide range of physical symptoms that are disabling now. I desperately want and need my life back. I went to a well regarded and very savvy psychiatrist and he concluded after some weeks of close questioning and examining bloodwork, that I had some infectious disease of unknown etiology.

Symptoms these days are burning feet and calves periodically, struggle breathing (not activity or anxiety driven), sore lymph nodes in throat and sometimes the groin, weak leg muscles that are often not responsive, numbness in feet,lips and eye sockets often, chronic geographic tongue that came from nowhere and hung around for the past 1 1/2 years, pharyngitis almost all the time.

There is no fatigue,so it is not CFS and my muscles do not ache, so its not fibromyaligia. But, what would you do in my situation...are there other tests that you would recommend to exclude HIV...are there more general tests that would declare the presence of any retrovirus? If there are still reactive lymphocytes on a blood smear, doesn't that mean a likely viralinfection and what virus would stay this long?

An MRI was negative last year except for a liver lesion which a PET Scan determined to be a cyst. A chromogranin test and a C reactive protein test were negative. So were Hep B and C tests,so I don't know where to turn. Can you please help me here? I would so much appreciate it...I just don't know where to go with the testing and how to get well again.I cannot believe I am this ill and the doctors have not yet found anything. I still suspect a possible variant of HIV that the diagnostic tests in the US cannot detect. Is this an impossibility?

Thank you so much!

Answer

Hello,

Now you can do better than sharing a few cold ones with a tranny, can't you? That hardly raises an eyebrow in this forum. OK, on to your problem. Now exactly which part of "No, it's not HIV" are you having difficulty understanding? You've had a megabucks workup and so far all you've come up with is a "savvy" shrink who "concluded you have some infectious disease of unknown etiology???" Psychiatrists are not infectious disease specialists and infectious disease doctors are not psychiatrists. I assume you've been to an infectious disease physician, considering the extensive workup you've had. If the infectious disease specialist says it's not HIV and not an infectious illness that you need to be concerned about, I would suggest you believe him. I also think it's important to have the infectious disease physician and your savvy psychiatrist speak directly to each other to come up with a unified plan. You are getting mixed messages, and that is why there is so much confusion here. I cannot diagnose your condition over the Internet, but I can tell you it's not HIV or an undetected HIV variant that is causing your symptoms. Many of your symptoms sound anxiety-related "burning" sensation, "struggling" to breath, "weak" muscles, "numbness," etc. Yes, reactive lymphocytes can mean you have or had a viral infection, but to jump to HIV or HIV variant or retrovirus is an unjustified quantum leap from point A to point B. "Viral infection" pertains to everything from a common cold to the flu to measles to herpes to Ebola! More than likely, your "reactive lymphocytes" are related to a common incidental viral infection.

My suggestions are simple: see an infectious disease specialist if you haven't already done so (which I would guess you already have); have that physician speak directly to your psychiatrist; and continue to follow up with your psychiatrist. Stop testing and chasing an illness you could not possibly have!

Good luck. Feel better.

Dr. Bob