[Question #3680] neuropathy /HIV

35 months ago
I developed in December 2016, burning, tingling sensation in my feet, primarily my right foot is the worst.  No cause found.
I tested for HIV in Jan, feb, mar, and April, 2017, for 4th gen tests,  all negative,  also in march, 2017, got a negative on an HIV RNA 1 qualitative test.  This neuropathy went away in June last year, but returned again in december.
I did test positive for herpes 1 and 2 last year in April ,  surprised because I never had any outbreaks in my life.
No 1-  can I discard HIV as the cause of symptoms, even though neuropathy  returned?
No 2-  will herpes have anything yo do with this?.
Thank you so much.



H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
Welcome to the forum. Thanks for your question.

1) Yes, you definitely can exclude HIV as the cause of your symptoms. Neuropathy is never the only symptom of HIV; it occurs sometimes in advance HIV, i.e. in people who are otherwise ill with AIDS, but otherwise it's not an issue. And your test results prove for sure you don't have HIV.

2) Herpes for sure has nothing to do with this either. However, I might have more comments about your positive HSV test results if you'd like to provide the details. Many positive HSV2 blood test results are false, depending on the exact test done and the numerical results. Let me know those things (including the numbers for both HSV1 and HSV2), and perhaps we can sort this out.

I hope these comments are helpful, at least as a starting point.

HHH, MD

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35 months ago
Thank you Dr.  last April 12, 2017.  I did a ten test panel Std check.  These are the herpes numbers.
HSV 1:  igG was 6.98
HSV 2:  igG was 2.48

Just last week,  retook the same test
HSV 1:  igG was 5.99
HSV 2:  igG was 2.08

Have never had symptoms in my life,  I'm 64.
These tests were thru labcorp.

Dr, was concerned about HIV, that is why I wanted to confer with you because I read on google that it could be an early sign of HIV?  Thank you for clearing it for me.  Was concerned because my symptoms lasted 6 months last year, went away, and they came back, but I guess I tested negative after these symptoms began last year the first time.
As far as herpes,  thank you for clearing it for me,  was concerned because I read that it causes neuropathy and nerve sensations?  But this long?, 
I do suffer from extreme anxiety, and more over this.


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
You have HSV1. So do about two thirds of all adults your age, so that result was expected. Most likely it is from a distant past oral infection in childhood. Probably you have HSV2 as well, but possibly not. HSV2 values over 1.1 are officially considered positive, but most truly infected people have results of 3.5 or higher. With your two results of 2.08 and 2.48, there's about a 50:50 possibility you don't have it. (Uncertainties like this is one of the main reasons that HSV blood tests usually are not recommended unless someone is at particularly high risk or has symptoms typical of genital herpes.)

You have misunderstood something you read about herpes and neuropathy. People with symptomatic herpes outbreaks can experience a neuropathy-like prodrome of tingling or similar sensations in the same general area where a herpes outbreak is about to occur. But neuropathy alone or continuous symptoms like yours do not occur with herpes.

Also, as discussed above, neuropathy alone is never a sign of HIV. Anyway, the HIV blood test results are much more reliable than symptoms, and your test results prove you do not have HIV.

Neuropathies are quite common at your age. If you are diabetic or pre-diabetic (e.g. if you are overweight), that's a good bet for the cause. Nutritional problems also could explain it. However, many or most cases have no known cause. I recommend you seek health care for a comprehensive medical evaluation; make sure you tell the provider all that you have said on this forum, then follow her advice about possible further tests and treatment. But in the meantime, you can be sure that neither HIV nor HSV is the cause.

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35 months ago
Thank you Dr.  shall I get the herpes western blot test?
And 
35 months ago
Dr.  Shall I get the western blot herpes test just to confirm?
And forget HIV, even if my symptoms went away and came back?  ,   I know I tested negative several times after my symptoms started the first time in December 2016.







H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
35 months ago
HIV test results never are wrong if testing is done sufficiently long after the last possible exposure. NEVER. And you had several different tests! Please stop asking about the possibility you have HIV. 

An HSV western blot probably would sort this out. But as I above, you should first consult with a knowledgeable health care provider and follow his or her advice. No matter what the WB result, you'll need in-person evaluation by an expert when the result is available.

That concludes the third reply to your original question and so ends this thread. I hope the discussion has been helpful. 
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