[Question #2784] No diagnosis 2 Dr.HHH

43 months ago
Dr HHH im back again, Ill try my best to summarize, Im a guy, had unprotected anal sex with a girl who was hiv positive, the problem is I had my symptoms nearly 6 months after exposure which was extreme fatigue, abdominal pain, diarrhea, night sweats, elevated liver enzymes and liver mildly enlarged, I did all tests STD's and it was negative also with HIV 4th generation, after the illness went away nearly after 2 weeks did  endoscop and I had mild ulcers cause of reflux, then after 2 weeks I got a painless node in the left post cercical area , then more nodes appeared with time, now I have nearly 7 nodes in arm pits and neck, went to the doctor and did all the tests I had elevated lymphocytes for nearly 6 months and returning back to normal " last one was 46", all tests negative HIV-Ebv-mono-toxo but CMV was pozitive for IgG but negative Igm and DNA, Im really tierd of all this as im still in high school and have a great GPA and reallt want to be a doctor, But  it wont be possible if I was infected, I tested for HIV after 6,7 twice, 8, nine, 12 and 13 twice months.. total of 8 tests, all where 4th generation tests except the last two at 13 months which I used ora quick, 
I still have symptoms like chronic heavy night sweats , diarrhea, thrush that went away after treatment, and the most important generalized lymphadenopathy that even my parents and the doctor dont know the cause 'my parents are doctors' Do I need more HIV tests? 
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Welcome back to our Forum.  As you may know, Dr. Handsfield and I share the Forum and today I happened to pick up your question.  FYI, I have reviewed your earlier interaction with Dr. Handsfield and I agree with all that he said.  Most importantly, he told you to believe your HIV tests and I agree 100% with him.  You have proven that you did not acquire HIV form the exposure you mention and there is absolutely no reason for additional testing.  you have PROVEN that you did not acquire HIV.

Your lymphadenopathy may be due to a CMV infection.  About 20% of mononucleosis syndromes are caused by this virus and the fatigue and swollen lymph nodes which occur as part of CMV mono can last for several months.  There is no specific treatment for this illness, one must just wait it out but it does reliably resolve without treatment over time.

I hope this reassurance is helpful to you.  It is time to not worry further about HIV- you have proven you did not acquire it from the exposure you describe. 
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43 months ago
Thank you doctor, What is the meaning of pozitive IgG but negative IgM and DNA?! And doesnt CMV only affect people with bad immune system? Because I had a terible ilness, 

2) Can I forget about HIV or do I need a PCR? Because I did what DrHHH told me and went to a infectious diseases doctor who told me that he cant do any thing for me after these negative tests?

3) I have high lymphocytes for about 6 months or more, but the problem is the absolute is normal but the percentage is very high, doesnt this mean that I may have low CD4 but very high CD8?

4)  I also dont think I have mono because I tested for it and it was negative, So can it really be CMV which is destorying My Immune system with the help of HIV

5) The girl I had sex with, she had many partners, so can it be that she had a new strain? Wont super infection cause the development of new strains

Last one, if not HIV.. what would make me lose 12 kg in this time period? With chronic darhia and night sweats that make me wake up the middle of the night.. I really want to stop this all but dont know how 

Thank you

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
1.  A positive IgG test but a negative IgM means that this is an older infection and you have had CMV in the past but it is not currently active.  Most people have had CMV at some time in the past, not just those with immune deficiencies.

2.  This is a repetitive question.  Repeating the question will not change my answer, which was the same as Dr. Handsfield's before.  I said above "You have proven that you did not acquire HIV form the exposure you mention and there is absolutely no reason for additional testing."  That includes PCR tests.

3.  No, this is normal variation.  As Dr. Handsfield already told you, I would not pay attention to these numbers and certainly see no reason for a CD4 or CD8 count.

4.  Mono tests test for Epstein Barr virus, but as I said above, 20% of mono is caused by CMV.  If you have further questions about mono, talk to your own doctor.

5.  No.  You are letting your anxiety get away from you.  You are not infected!!!

Many things, including pathological anxiety and ulcers can cause weight loss. Your focus on HIV may be keeping you from finding out what it really causing your problems.  EWH
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43 months ago
Thank you doctor Hook you both are from the top at your feild so thses comments calmed me down, 

In last question you said no at question 5) why is that not possible?  And if I took a last Pcr test which one is better RNA or DNA? Because I think this test will make me believe my status even with un explained lymphadenopathy, nigh sweats, diarrhea and weight loss

I cant really get what was the cause of lymph node because I went to a hematologist and an infectious diseases doctors, I tested for nearly every single disease out there, but they were all negative and both refuse to give me a biopsy, as you see no any reason other than HIV .. thank you so much and wish me luck if every thing goes well and I  joined med school
Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Sigh, you just can't get over this, can you.  If you had a "new" strain of HIV it would have been detected by your tests.  Different HIV strains are still detected by tests for the infection, particularly when the test looks for two different indicators of infection as the 4th generation tests do (HIV antigen and HIV antibody).  RNA and DNA PCR tests perform equally and will give you the same result-negative!Your chance of having HIV from this exposure is about as high as your chance of having been attacked by an alien from outer space. 

This is my 3rd response to your questions, therefore as described on the website, this thread will be closed in a few hours.  Take care.  EWH
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