Medical Intern with a question

Question

Dr.Hightow-Weidman,

I am a medical intern in Ohio and have a concern about HIV. I will try and be brief.

29 y.o M with a previous act of unprotected intercourse 8 years ago during undergrad. 2 wks after painful ejaculation / urethritis. 3rd week post-intercourse viral illness : cough, conjunctivitis, exudative pharyngitis/laryngitis, low grade temp 100.4.

Testing was extensive- Undetectable viral load 6wks out & Neg Ab testing 3 , 6 , and 12 months.

4 years after - neuropathy in feet. 7 years after during medical school and after a dental appointment - Oral Thrush. Treated w/ Nystatin, clomitrazole and fluconazole because it was remittent to treatment.

Requested 4th generation P24 Ag-Ab combo- Negative / Not-detected. Qualitative RNA and DNA PCR - NOT-DETECTED.

Requested CD4 = 521 (abs Lym: 1.57; percentage: 22%; Neutrophils; 72%)

Now intern year ~8 years later burning returned on Palate . Looks like Median Rhombid glossitis and white on buccal mucosa.

Oraquick HIV advance 1/2 : test- Negative.

  1. As an intern I understand the tests are negative but is HIV a possibility still? 2.is the CD4 count at 521 a concern? I was told it was not but question that?

Thank you for your time Doc. Looking forward to hearing from you. My Best.

Answer

Hello there HIV is not a possibility. Your CD4 count is a bit on the low/normal side and my guess is that it could be related to stress. You are an intern! I wouldn't worry about HIV and would focus on your studies. good luck take care Dr. W