[Question #12251] Weight loss and hiv fear -followup

9 months ago

Dear Drs,

I am back again with certain queries .

I read Dr Hansfield response in one of the forum saying , though no obvious risk exposure , rapid weight loss should trigger for hiv test . Would like to clarify the following :-

a. Based on my exposure and currently only experiencing weight loss past four months about 6kg , do i still have risk based on Dr.Hansfield response to one query in forum.

b. does rapid weight loss without any symptom alone trigger this or weight loss with other multiple symptoms . What are the other multiple symptoms associated with weight loss which trigger for hiv test.

c. i had exposure with hiv positive who said he is under treatment and undetectable . the exposure was mouth kissing , rubbing penises glans together with precum , frottage and very fast dipping . under this circumstances do i expose to that risk of hiv infection.

d. how early weight loss occur in hiv infected person . is it within 1 to 2 years upon infection.

Gastro did ultrasound, endoscope and colon scope . No invasive malignancy . Next they plan to do CT TAP. If this also no any finding contributing to weight loss (assuming) , what else could be the cause of the weight loss.

Can anxiety and fear cause weight loss ?

My exposure was :

June 2022 , September 2022, December 2022 . all no anal penetration and no oral sex.

June 2022 was lately ofund out with hiv infected person who said under treatment and undetectable. I am really worried and in fear . Hope Dr can enlighten me . I am sorry if this post no adhere to the forum policy. I am residing in Malaysia.

Edward W. Hook M.D.

9 months ago

I am disappointed that you felt the need to return to our forum. I suspect that you have taken Dr. Handsfield’s statement out of context as I am sure he would agree that I’ll with all that I have already told you. I’ll go straight to your questions.:

1. In the absence of a meaningful exposure, there is no reason that the situation you describe would trigger testing for HIV.

2. See above. If there are specific, new symptoms that you were concerned about please describe them, but I doubt that they are in any way suggestive of HIV infection.

3. The exposure you described did expose you to an infected person however because that person was on effective therapy, there was no risk of transmission of his infection.

4. Late in the course of infection, after a period of years. Anxiety can certainly cause substantial rapid weight loss.

My recommendations are unchanged. If you remain concerned about HIV, testing at this time which will be conclusive, will prove that you are not infected. You need to put your fears and anxiety aside and find a way to move forward. EWH.

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9 months ago

Dear Dr ,

Thanks for your reply.

I am referring to Dr Hans response to Question #5364 .

Pertinent to my symptoms , i do not have any other symptoms . I only experience rapid weight loss.

Please enlighten me on the following :-

a. what are the other symptoms together with rapid weight loss that may trigger for hiv test ?

b. is it possible to have rapid weight loss 2 to 3 years upon infection?

c. naturally my stool sometimes hard and sometimes soft . but i never experience any watery motion like diarrhea persistently . I heard weight loss with chronic diarrhea or continuous fever is indicative of hiv infection. Is that true ?

d. i always in fear of infecting my wife and my 3yo kid. assuming maternal infection , at 3yo the child will be very ill right ? what are latent infection symptoms in 3yo child if acquire at 1yo during breastfeeding ? i m very paranoid.

e. in fact penises glans without foreskin rubbed each other or make contact with precum does not pose a risk for hiv . am i correct hiv does not infectious outside of the body . In one of forum you stated ejaculation need to occur inside vaginal or anal during penetrative in order for the transmission of hiv to happen . Is that valid under all circumstances ?

f. will penis glans contact with blood pose hiv infection . or bleeding gum deep mouth kissing also pose a risk ? i read many forum , you stated zero risk for transmission .

g. hiv people under ART will not transmit hiv or only those undetectable will not transmit hiv.

h. dipping spontaneously is zero risk ?

I am very confused, fear and paranoid Dr. I sincerely apologize and hope you can enlighten me on this . really appreciate a lot for your kind ness. You and Dr Hans are saver of human life and humanity.

9 months ago

The main problems that would be most typical of HIV -- the ones that might trigger a test even in someone without obvious risks -- are unexplained weight loss; lymph node enlargements in various body areas; certain skin conditions, notably unusally dry skin body wide, and severe seborrheic dermatitis (dandruff), especially if it extends onto the face; white patches in the mouth (yeast infection, i.e. "thrush"); repeated episodes of certain infections, especially pneumonia (and sometime the first episode, if the cause seems unusual); and chronic or recurrent diarrhea. I'm sure there are others that don't immediatley come to mind, but these probably are the majority

The above is Dr Hans reply in question #5364

Edward W. Hook M.D.

9 months ago

You are wasting your time and mine- trying to apply a nearly 5 year old reply to a different question to your own situation. My assessment and recommendations are not going to change. I reply to your follow-up questions:

a. what are the other symptoms together with rapid weight loss that may trigger for hiv test ?

Answered in the quotation you provide.

b. is it possible to have rapid weight loss 2 to 3 years upon infection?

Very unlikely

The diarrhea of LATE HIV (after 8-10 years of infection) is continuous and dehydrating, not intermittently soft as you describe. Anxiety can cause diarrhea

You're being paranoid. If you can move on, you should test, as I've already recommended. Stop your paranoid worrying.

you are correct. Contact with pre-ejacuate outside of the body does not put you at risk.

f. will penis glans contact with blood pose hiv infection . or bleeding gum deep mouth kissing also pose a risk ? i read many forum , you stated zero risk for transmission .

If you have read in the past that these are zero risk events, why are you repeating the question. The answers are not going to change.

g. hiv people under ART will not transmit hiv or only those undetectable will not transmit hiv.

Persons on HIV therapy who have HIV viral loads of less than 10,000 virtually never transmit their infections

h. dipping spontaneously is zero risk ?

Correct.

You have one followup. After that the thread will be closed and no further follow-ups will be accepted. Should you return despite this warning the question will be deleted and your posting fee will not be returned. You should not return using another user name or e-mail account wither. If you do, we will do pur best to ban you from the forum.

If you want to address your concerns, get tested after committing to accepting the results. EWH

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9 months ago

Dear Dr ,

Thanks for the clarification.

Can i establish or clarify the following :-

a. is it confidently can say that weight loss alone without other symptoms does not trigger for test for zero risk exposure ?

b. assuming maternal infection , at 3yo the child will be very ill right ? what are latent infection symptoms in 3yo child if acquire at 1yo during breastfeeding ? please answer this

c. what could be other STI that can cause rapid weight loss . i had done hep a,b,c test and all negative . syphilis also negative.

d. The diarrhea of LATE HIV (after 8-10 years of infection) is continuous and dehydrating, not intermittently soft as you describe. Anxiety can cause diarrhea.

In latent stage , any other symptoms in contrary to Late HIV diarrhea

e. can i confidently said was zero risk exposure and no testing required . i know you will always recommend testing for assurance under zero risk exposure.

Dr , please forgive me and don't get me wrong . my situation as such . i hope you can understand and my sincere apology.

Edward W. Hook M.D.

9 months ago

Final replies to your repetitive questions:

a. is it confidently can say that weight loss alone without other symptoms does not trigger for test for zero risk exposure ?

Correct

b. assuming maternal infection , at 3yo the child will be very ill right ? what are latent infection symptoms in 3yo child if acquire at 1yo during breastfeeding ? please answer this

Most probably but not absolutely. You have no evidence your sife is infected

c. what could be other STI that can cause rapid weight loss . i had done hep a,b,c test and all negative . syphilis also negative.

None

d. The diarrhea of LATE HIV (after 8-10 years of infection) is continuous and dehydrating, not intermittently soft as you describe. Anxiety can cause diarrhea.

In latent stage , any other symptoms in contrary to Late HIV diarrhea

Correct

e. can i confidently said was zero risk exposure and no testing required . i know you will always recommend testing for assurance under zero risk exposure.

Correct.

This thread is complete. Please do not return. EWH

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