Problems Down Under

Question

Dear Dr. Bob

I wrote to you about 12 months ago after having had an exposure (unprotected sex with female of unknown status) in 2004. Following that exposure I had a cough that lasted nearly 3 months. I have since had ongoing problems such as dermatitis, peeling/cracked lips, chronic bleeding/receding gums, periodontal disease, folliculitis on arms/legs, and I also appear to bruise easily. I have completely convinced myself that this is all due to HIV.

I had a total of 6 antibody tests (Abbott Asym and Abbott HIV 1/2 Combo) over a period of 2 years - these tests are approved for use in Australia but not in USA, plus I had a DNA PCR for HIV1 - all test results were negative/undetectable. CD4 count was over 700. The lady in question also provided me with a negative test result but I place little credence on this as she has been difficult to say the least.

My question is whether I can rely on my own results. This is because I understand that some people fail to make antibodies and/or the Elisa test results may not always be accurate and I have also read that HIV2 cannot be picked up by PCR. If it is not HIV what could be causing these strange symptoms? I was consistently healthy prior to the above incident and have had no subsequent exposures.Do I need more testing?

Finding it increasingly difficult to get through the day so any advice you can give me would be much appreciated. Thanks so much in advance.

Answer

Hello Problems Down Under,

You're still worried about a potential exposure in 2004 despite:

  1. six negative HIV-1/HIV-2 tests out to two years;

  2. an undetectable DNA PCR;

  3. a normal CD4 count;

  4. a negative test from the "Sheila" with whom you rooted like a wombat.

Hmm . . . mate, I don't think you have "problems down under," but rather problems up top. In other words, I think there may well be a few "roos loose in the top paddock," so to speak.

Do you need more HIV testing? No, of course not. You need a good shrink to help you accept the truly wonderful news that you are absolutely, conclusively and irrefutably HIV negative. Whatever is causing your symptoms, one thing is absolutely certain: it's not HIV!

Mate, it's time you put those irrational fears permanently to rest.

G'day!

Dr. Bob