[Question #11068] HIV-Seronegative

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17 months ago
Hello doctors and sorry to come back again (1rst case “Clarification / HIV / Symptoms”)

Been almost 12 months since I've had various recurring health issues. Node in the groin and neck are painful, several balanitis, several ulcers in the mouth/tongue that come and go, diarrhea for 12 months, shingles (I'm 39yo). 1 week ago, I had a pneumonia and I started the medication. My voice, cough and breathing don't seem to be getting better. I think it's PCP. I did 4 x 4th gen tests (1, 3, 8.5, 11 months) and viral load test for HIV-1 only. I know it’s really rare but I believe I’m HIV-seronegative and I have HIV-2. I know it cannot be HIV-1.

Q1: Is 3.60 white blood cell could be someone who has AIDS?
Q2: Is 19.53 relative monocyte could be someone who has AIDS?
Q3: An article was written in 2019 concerning HIV-seronegative cases. Is this still possible in 2024?
Q4: In the case that I am HIV-seronegative, what should I tell my GP because she just recommends me medication for anxiety.
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17 months ago
By the way, I would love doing a viral load for HIV-2 but in Canada, we absolutly need a 4th gen positive result for that..
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H. Hunter Handsfield, MD
17 months ago
Welcome back. However, having read your recent discussion with Dr. Hook, there really isn't much more to say.

As Dr. Hook said, it is 100% certain you do not have HIV, and that includes HIV2. You don't need an HIV-2 RNA/PCR ("viral load") test to be sure you don't have it.

It is not possible to have HIV symptoms and not test positive. It simply never happens. Your negative HIV tests (of various types) are incontrovertible proof none of your symptoms is caused by HIV of either type. They also prove that the minor blood count anomalies you report cannot possibly be due to HIV. What should you tell your GP? I would advise you to respect her diagnosis and treatment. While I'm not in a position to judge the actual causes of your symptoms, certainly many if not all of them could be due to anxiety.

Those comments cover all four of your questions, but to be explicit:

Q1,2) Someone with HIV could have such blood counts. But HIV is not a possible cause in you.

Q3) "Seronegative" means absent HIV antibody. You not only have no HIV antibody detected, you also were negative for HIV antigen (i.e. the virus itself) in at least two AgAb (4th generation) HIV tests. Also, the exposure you describe was zero risk. Nobody in the world ever caught HIV from the events you described in your previous question.

Q4) Tell your GP that you finally trust her judgment, that you know you don't have HIV, and that you promise to stop asking her about it! You cannot go through life attributing every twitch, tingle, or natural body aches and pains to a single non-risky semi-sexual event that you likely have mixed feelings about! If you continue to remain concerned, I suggest 1) go back and re-read your previous discussion (carefully, every word) with Dr. Hook; and 2) consider professional counseling -- your GP undoubtedly would be happy to discuss that option with you.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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