[Question #3478] Really strong Symptoms

37 months ago
Hello Doctors,

I understand the repetitive questions about the same exposure are avoidable and I also clearly understand that anxiety driven questions don’t help other users which is the main purpose of this forum. Trust me when I say this I’m a balanced person, well atleast till this incident.

In my previous discussions with you I’ve been assured that I can forget HIV as testing is conclusive at 6 weeks beyond for ag/ab tests. After having an ag/ab test CMIA at 65 and 82 days post exposure which was negative I’m having now a series of symptoms. First I’m getting a very strong pain in my left knee, it’s actually just behind the knee and continues to the calf. Second, very frequent urination,. Third, a strong throbbing /shooting pain in both my underarms. Fourth, boils around my mouth on the outside near my lips and last an ulcer right inside my mouth. All these happening together. 

I’m not back here because I’m crazy but because I need help. These symptoms are happening at the same time and I’ve not experienced anything like this before. Such a strong pain in my underarms... never. I’m now 4 months from my exposure and I haven’t done any tests after the 82 day duo. I don’t know what to make of all this happening to me at the same time. Please tell me what do you suggest, do you think I should test once more for HIV?  Just please help me and please understand that i would love to move on and believe my test results and carry on with life and enjoy it. I’m here because ONLY and ONLY post my exposure am I constantly experiencing these things. I’ve not got so many boils with pus on my face, I’ve never had a swollen part behind my knee, armpit pains and all happening together at the same time ???? How’s that possible ? 
37 months ago
Yes one more important thing forgot to add that over and above all the others things i mentioned I have this very weird thing on all my nails. It’s like if you bite your nails and only the top layer gets bitten or a certain layer of the nail gets bitten and starts peeling off. It’s kind of unusual but I see that on nails of both my hands and it’s noticeable. All I want to ask you is that ALL these things happening to me are something else and 100% not HIV because I got a 65 and 82 day duo negative??? The most unusual part is all these happening at the same time which is so scary 
37 months ago
You must know one thing that although I know and understand clearly that repeat questions are not welcome but in my country and city I’m not going to find experts like you, with your level of credentials. I’m here because I strongly believe and trust what you say will be right because your expertise and experience. A doctor on healthtap not naming anyone said get a NAAT at 6 months to be sure but I don’t believe that, I trust you would guide me right and that’s why I’m here. 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
I'm sorry you have not been able to accept our assessments regarding HIV from you exposures four months ago.  REpeating your questions however does not change the facts- your HIV test results are already conclusive and prove that you do not have HIV.  Further, HIV does NOT cause the sorts of symptoms you are reporting- it does not cause need pain, leg swelling , or finger nail abnormalities.  Many other medical conditions cause swelling of the glands under the armpit and mouth ulcers.  Further testing for HIV will not change that you did not acquire HIV four months ago.  My advice, and my only advice for you is to put your concerns about HIV aside and see a doctor to get their assistance in sorting out what might be truly causing any symptoms that you might have.  EWH
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37 months ago
Thank you doctor. Please don’t reply to this as I want to keep my follow up if needed or anything else appears. I am getting home in the next 10 days and I will take an appointment with my family doctor but I’m not going to mention my exposure and testing to him, I can’t. I will update you once I meet him and have a discussion with him on what he may feel post examination. Thank you !! Have a nice day. Please keep my thread open. 
37 months ago
Dear Dr.Hook,

Although I thought I will not waste my follow up questions till I get home and meet my family doctor and then update you post examination by him. I have 5 more days to get home but suddenly when I woke up today morning, I felt a slight discomfort in my lower lip, I went to the mirror to notice inside my lower lip a white fungal infection. When I used my tooth brush to brush off the white skin which is on the inner side of my lower lips, in panic I brushed hard and it started bleeding. This fungal infection is something I have never had and is completely unexplained. I don’t want to give a live update on my condition but the glands behind my left knee swollen without any reason, pain in underarms completely unexplained and now this infection without any reason Whatsoever. I’ve seen many many replies on this forum where you have said 6 weeks conclusive and I have had two tests after 6 week mark with NO exposure at all in this duration. Trust me I’ve never had such unexplained things happen to me ever EVER. Have you heard of testing in India. Is it reliable? Are all CMIA tests relible? I don’t know what to do. This fungal infection out of nowhere has now totally thrown me off balance. Why is all this happening to me at the same time. I was dealing with the knee and under arm pains and now this. Are there lymph nodes behind the knee? Anyway I’m going to save my second follow up now till I get home. Please tell me that come what may even after this you feel that I still don’t need to be concerned about HIV. Thank you Sir. 
37 months ago
One more thing sir, is there any strain that the test may not cover in your knowledge or is there any strain of HIV2 that I need to request. Do these tests cover each and every strain. The reason I ask this is because I simply can’t see think of any possible reason for all these unexplained things. I somehow feel that I have it because I honestly honestly see no other possibilities. One coincidence , second coincidence and now this third coincidence. The rash and flu I got 10 days after was a coincidence and now all these things as well are a coincidence. How many coincidences are possible?? Hope you understand my situation sir and what makes me think like this. There is something happening and I FEEL IT FOR SURE. TRUST ME SIR. What do you feel I should do? Something’s not right and that’s certain. HELP ME PLEASE!!!!
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
I repeat - "My advice, and my only advice for you is to put your concerns about HIV aside and see a doctor to get their assistance in sorting out what might be truly causing any symptoms that you might have."  None of these additional, self-perceived symptoms warrant any concern.  Your HIV test results are conclusive.  As I indicated before, your symptoms and concerns in no way supercede the fact that you have conclusive HIV test results.  The help you need is with your misplace guilt and anxiety.  EWH
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37 months ago
Dear Dr. Hook, 

Hope you had a good weekend.

I’m home and I met my family doctor today. Upon examining the swelling in my under arms and swelling behind my knee, he felt that the lymph nodes are swollen and my system is fighting some infection. I informed him I’ve had these since 3 months now. Surprisingly he asked me if I had any sexual exposure. I told him about my exposure and testing. Going through my test results he assured me that HIV1 was not my problem but he said I must take another test at 6 months to rule out HIV2. He said most studies have been done in North America where HIV2 is very rare but in India it’s not so rare. Although, mostly found in West Africa it has made its way into India and there have been a lot of HIV2 cases reported in India. He told me that 95% of the HIV cases in this world are HIV1 cases and all studies with regards to window period and treatment are mainly for HIV1. Also, the antigen of the duo test that looks for P24 antigen is a HIV1 antigen and not a HIV2 antigen. Now I’m again back to square one just from where I started. 
Is all the information he gave me true?
When you says 6 weeks conclusive you mean it for HIV2 as well. Does this apply to mainly North America and not INDIA.
Do I test again at 6 months to rule out HIV2 infection?
He said the chances of HIV2 are rare but it’s important to rule it out, is that correct? 

Please tell me what do you suggest I do now? I know this is my second follow up and you will reply and close the thread but before you do please explain to me my road ahead. PLEASE. He agrees with 6 weeks conclusive for HIV1 but is very clear that for HIV2 it’s a 6 month window, also a PCR for HIV2 won’t help because the virus replicated at a much slower pace than HIV1. Need your expert opinion now.  Thank you for being patient and Thank you for all the guidance. In one of my interactions I told you the reason I returned on the forum was because I will not find experts like you and Dr.HH in my city. THANKS 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Final responses.

You are correct that HIV-2 is more common in India than in the United States and that my perspective is largely shaped by the U.S. experience HOWEVER, if you are symptomatic (i.e. your swollen lymph nodes are due to HIV-1 or -2) AND 3 months has passed since your exposure, your tests would be at least indeterminate.  Further more, while HIV-2 is RELATIVELY more common in India, the vast majority of HIV infections in India are due to HIV-1.  Your negative tests indicate that your swollen lymph nodes are not due to HIV.  Your doctor is being cautious and that is understandable but the probability that you have HIV-2 or that it is the cause of your swollen lymph nodes ins miniscule.. 

In answer to your specific questions:
When you says 6 weeks conclusive you mean it for HIV2 as well. Does this apply to mainly North America and not INDIA.
See my comments above. 

Do I test again at 6 months to rule out HIV2 infection?
Testing is your own decision.  I remain confident that you do not have HIV-2 (or -1) from the exposure you have described.

He said the chances of HIV2 are rare but it’s important to rule it out, is that correct?
At this point, to be completely thorough, ruling out HIV-2 is reasonable but the likelihood that your swollen lymph nodes are due to HIV-1 are miniscule and, in my opinion, not something to worry about.

As you point out, this is the 3rd response to your 3rd set of questions.  By now it should be quite apparent that my assessment and advice is not going to change.  This thread will be closed later today.  EWH
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37 months ago
Ok Dr. Hook. Thank you. Bottom line that my tests weren’t conclusive. There is that miniscule chance of HIV2 and we need to rule that out but you and Dr. HH told me my tests are for sure conclusive. Dr.HH said not possible to have HIV with my tests and you said further testing is a waste of time and energy. That applied for HIV2 as well right ? 
Edward W. Hook M.D.
Edward W. Hook M.D.
37 months ago
Yes.  EWH
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