[Question #3619] Chronic sinusitis symptom

35 months ago
Hello, Doctors - I have been on here a few times already and wanted to check back in with another question. 

My background: 
I had an unprotected hetero- intercourse exposure approx 19 months ago. 
I tested negative at 5 weeks (duo) and again at the 6 month mark (duo). 

In my last thread, I mentioned I had to get one of lymph nodes removed in my neck because it was so large and wouldn’t go down. They tested it to see if it was lymphoma and it came back clear. 

The last 4+ months,  I’ve been trying to manage my sinus infection problems. Before this, Ive never really  struggled with allergy/congestion issues.  
Recently, I was diagnosed as having Chronic Sinusitis and have been placed on 6 weeks of antibiotics. 

I have just read that chronic sinusitis is a very common symptom of advanced HIV or someone with HIV who is not on treatment. 

I think my lymph node complication and now being diagnosed as having Chronic sinusitis has got me spooked again. 

I’ve read threads where you’ve mentioned that sinus/congestion problems are not symptoms of HIV. But, credible web sites like Mayo and Medhelp, etc. have chronic sinusitis listed as a very common symptom. 

At 19 months removed from my exposure, would being diagnosed as having chronic sinusitis fit the timeline if I was hiv+  without treatment? 

Thank you. 

Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
Welcome to the Forum.  Your question raises an interesting, important, and complicated issue.  (BTW, I am not able to find your earlier posts, perhaps you have changed your user name or perhaps it is a shortcoming of our software). 

There are a number of medical syndromes which are ASSOCIATED with HIV. In medical/epidemiological situations however, while associations raise awareness of the possibility of HIV, they are not causal (i.e., not everyone with sinusitis or swollen lymph nodes has HIV.  In fact, most do not although a higher proportion of persons with these problems have HIV than is the case in the general population).   For HIV, these sorts of associated problems include sinusitis, fungal infections (vaginal yeast and thrush), swollen lymph nodes and a number of other medical problems which are common and tend to be somewhat more common in persons with HIV than persons who are not infected.   When problems of the sort I mentioned (including chronic swollen lymph nodes or sinusitis) , they are clues which should stimulate physicians to look a bit harder for associated diseases (like HIV). but, when the tests for those diseases are negative, it is time to move on.  Thus when a person has chronically swollen lymph nodes or sinusitis, the right thing to do is to look for ASSOCIATED diseases such as HIV.  When the tests are negative however, it is then time to stop worrying about that possibility and look for other causes or chalk things up to bad luck.

I hope this explanation is helpful.  An analogous situation is that not everyone over 6"5" plays basketball in the NBA (professional basketball) but more people in the NBA are 6'5" than persons who are shorter.

Finally, my guess is that you are looking to the internet to help you understand what is going on.  BAD IDEA.  Much of what is stated on the internet is taken out of context, out of date, or just plain wrong. 

All of this is a long winded explanation why you should NOT relate your sinus problems (or your swollen lymph node) to HIV.  Your tests PROVE that this is not the problem.  I hope this explanation is helpful  You need to not worry further about HIV.  EWH
35 months ago
Dr. Hook, Thanks for your specific reply.  I have a few follow up questions, if that’s okay. 

1) To be clear, you have enough confidence in my two tests that you would not recommend further testing even with symptoms that line up with chronic HIV symptoms?

2) Aside from the test results, does 19 months even match up to the correct timeline of having chronic sinusitis due to hiv? 

3) I’ve read that chronic sinusitis symptom occurs mostly in the later stages of HIV and that 19 months would be early.  You start to see these symptoms more around the later HIV stages(5 plus years mark).  Does this sound accurate? 

4) Since you recommend not looking online for answers,  are you able to speak or educate me on HIV symptoms that occur in the 1 to 3 year stage? I think it woul be helpful for me and perhaps others to get the textbook answer to that. 

Thanks for everything you do on here. You both always seem to provide detailed responses and customize your answers to each individual. It’s very much noticed and appreciated. :) 

Edward W. Hook M.D.
Edward W. Hook M.D.
35 months ago
1.  Correct.  Your test results prove that you did not get HIV from the exposure you have described.  There is no medical/scientific reason for further testing.
2.  No, the sinusitis which is somewhat more common amongst persons with HIV tends to occur in persons who have had HIV for many years.
3.  Repetitive- see above.
4.  Sigh.  It appears you are having trouble moving on.  HIV is most typically asymptomatic for 5+ years after the brief period (several weeks) when symptoms transiently occur in some (about half) of persons who have HIV.  If you are worried about HIV, test as you did- then believe the results and if the symptoms still concern you, look for alternative, non-HIV explanations. 
35 months ago
Your answers are greatly appreciated Dr. Hook. I am ready to close this thread. Have a great weekend. Thanks. :)