Question about testing.

Question

Dr. McGowan,

If you saw a patient and saw a certain constellation of symptoms that you really felt were caused by HIV, yet the patient tested negative even out to 6 1/2 years past possible infection, what would you do?

I mean do you ever try a biopsy or something other than just an antibody test every 6 months or a PCR?

Have a friend with Lipo issues, very very similar to what people are talking about on here. The thinning face, legs, and buttocks, and growing stomach. No real sickness and his CD4s are fine, but this really seems like the MO of HIV.

ID doctors just say its' not HIV, but give him nothing else to check for. He's already checked for common STD's, mono, and lyme disease. Is it worth checking for HTLV or XMRV?

Thanks,

M.

Answer

I would agree that HIV is not the cause. The symptoms of lipodystrophy with a growing stomach and thinning face, etc that you describe are not caused by HIV alone...these symptoms were seen with HIV when it was under treatment with some of the older drugs that we no longer use. So undiagnosed HIV would not be the cause.

This may be Cushing's Syndrome which is caused by a hormone imbalance. It would be important for your doctor, or an endocrinologist to do tests to look for this condition.

Best,

Joe