Bsline:Male, prev healthy; WBC ~4.5, TLC 1.6–2.1, CRP 0.2, ESR <10

Day 6:ARS-like (sore throat, fatigue), new inverse psoriasis rash

Post-ARS Day 10:Severe GI dysbiosis after recent abx + probiotics

:WBC 5.7, TLC 1.22; relief after stopping probiotics

Wk 4:WBC 5.3, TLC 1.9; HIV/STD neg

Wks 5–7:HIV Ag/Ab + RNA/DNA PCR neg; CD4 432(32%), CD8 443, ratio 0.97; ang cheilitis, severe balanitis, seborrheic dermatitis, reactive submental LN in US; CRP 0.5, ESR 8

Wk 9:EBV/CMV neg; CD4 421(36%), CD8 355, ratio 1.12; TLC 1.1; Ig normal

Wk 12.5:HIV neg; worsening GI/skin fungal+staph disease, ; fluconazole → GI relief, constipation returns; LN shrinks; SIBO neg; WBC 4.5, TLC 1.45; stool/CMP/O&P neg

Wk 14:Linzess started; cheilitis resolves; ESR 18, LN bigger

Wk 15:CT/MRCP/MRI: mild focal intrahepatic ductal dilatation (R lobe)

Wk 16:Post-meal pain,tired (Candida); add avocado oil ->improves bile flow, motility,energy, 

Q: Novel HIV-like retrovirus vs bile-tropic pathogen? blood mNGS? please help

However, I'm afraid I can't help much. You don't describe the exposure on your mind, so I can't comment on your risk for HIV or other STIs. In addition, we limit our advice to HIV and other STIs and I won't speculate on possible causes of your symptoms, except to say that you definitely do not have HIV. Your problems appear to be primarily gastrointestinal, which doesn't fit with HIV or any other retroviruses that I know about. Inflammatory bowel disease might be the best explanation. I don't know how to interpret "tired (Candida)" but I see no reason to suspect Candida or any other yeast or fungal infection. Most likely you have no infection at all -- the symptoms certainly could be various non-infectious conditions including IBD. I have no experience at all with metagenomic next generation sequencing (which I presume is what you mean by "blood mNGS"). In addition, I doubt you have anything at all related to whatever risk factor or exposure you might have experienced a few months ago.

Presumably you have seen a doctor, perhaps more than one; I would advise you continue to work with them. Best of luck in working things out.

HHH, MD