[Question #4281] Follow up on [Question #4243] Single act 16 years ago

29 months ago
Hello Doctor

I have been away with work but now im back and have ordered a home test kit.

I have some follow up questions if that is ok?

1. I keep reading about Long Term non progressors going 15-20 years? have you any experience in this, if so what is your defintion in how long a LTNP would go without progressing to Aids? 

2. In regards to my symptoms, with OHL, i scrape away the translucent white mark of my tongue and it grows back, does this sound like OHL or something benign like frictional keratosis?
With regards to Peripehral neuropathy how would you describe it? I read it starts symmetrically at the toes and doesnt come and go. the buzzing i get in my foot comes and goes (in terms of weeks of nothing), its not symmetrical and not in my toes. does this sound like peripheral neuropathy youve seen?
I have quite bad stomach cramps with mixed loose stools and constipation in the last week. Ive been to the GP before about this and we did some normal tests and all came back fine, he thinks its IBS. its kind of draining!

3. the tests we did for the IBS one of them was a CBC back in late feb and everything was in normal range. I know you cannot use a CBC to diagnose HIV but in your experience if someone was untreated for approx 16 years would there be any red flags or abnormalities? My lymph count was 1.5 and approx 25%

Thanks for the help Doctor. I cannot help thinking im out of the norm here in terms of being a long term non proggressors?

Thanks
29 months ago
I should add normal range in the lab for Lymphocyte  was 1.1 - 3.0
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Welcome back, but sorry you found it necessary. I have reviewed your recent discussion with Dr. Hook and agree entirely with his reasoned, science based advice.

There is no chance you have HIV. However, you are doing the right thing to be tested. In the meantime, it is pointless to ask about atypical symptoms, long term progression, and things like that. The test results always overrule symptoms and that's what is going to settle the issue. 

1) Long term nonprogression is extremely rare, and even in those cases, most persons have some symptoms that lead to diagnosis long before this.

2) HIV/AIDS might cause these symptoms, but only in people with advanced HIV and multiple other health problems. By themselves it is impossible they are due to an HIV infection or any other sort of immune deficiency. We see symptoms like this almost entirely in AIDS patients nearing death, not in outwardly healthy persons. 

3) Some but not all people with longstanding HIV would have various abnormalities in CBC. That normal result several years ago says nothing either for or against you having HIV at this time.

My advice is to completely ignore any and all symptoms until you have been tested, and disregard any and all new "what if", "yes but", or "could I be the exception" thoughts that may come to mind in the meantime. So please no more questions about any of this until you have been tested and post the result. OK?

HHH, MD
---
29 months ago
Thanks Dr.

The normal results I had on my CBC where from this year. 

1. Would you expect any changes after 16 years?

2 . Also I had a couple cases I think of Herpes on the roof of my mouth last year following food burns. What significance do you think this is? Can you get Herpes on the roof . I don't think I've ever had a coldsore!

3. Have you ever seen anyone go 16 years untreated? I see you usually state approximately 10 years. 

4. Does my buzzing in my foot that come and foes sound like peripheral neuropathy seen in HIV?

Sorry for the questions and I know you must be frustrated but I have to wait for the test so as you can imagine I am anxious.

Many thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
Please, please, please stop speculating and asking quesitons about things that are less probable than being struck by lightning. Also I encourage you to re-read your discussion with Dr. Hook. None of these symptoms even remotely hints at HIV, despite what you think you have learned in your apparently compulsive web searching. 1) Yes, bu not always. 2) Oral herpes outbreaks rarely occur in the mouth; probably something else, e.g. canker sores. In any case, recurrent herpes is no more common in people with or without HIV. 3) My experience is irrelevant. It happens I have never cared for a long term nonprogressor, but rare things happen. I also have never had a patient who had been struck by lightning, but that doesn't change the odds you will be struck, does it? 4) No, not at all. Also, in regard to your supposed OHL, I'm sure you don't have it. Maybe google lichen planus for photos of the most common conditions that mimics OHL.

One final comment about testing. Why are you waiting for a home based antibody test? Some such tests use older technology (2nd generation) that misses a few infections. For 100% conclusive result, see a doctor or clinic and have a proper, lab-based antigen-antibody test.

Perhaps it will also interest you to know that in the 14 years I have been moderating this and a preceding similar forum, with thousands of questions about HIV risk and fears, there has never been any user who was worried about a possible HIV exposure or symptoms who turned out to test positive. You will not be the first. If and when that happens, it will surely be from a user with a real risk, not the virtually zero risk situation and non-significant symptoms of the sorts you have described in your two threads. This is like worrying about a lightning strike or, perhaps even more accurate, being struck by a meteorite. I cannot guarantee that won't happen to you, but I would not urge you or anyone else to take any steps to prevent it.

Repeated anxiety driven questions are against forum policy and generally receive curt replies or none at all, without refund of the posting fee. This being your second question, it will have to be your last. And on this thread, you have one more follow-up comment and reply. I suggest you save it until you have your HIV test result, which you can post for a final comments. (Threads are closed after a month of no comments, so you would need to post your result before then.) In the meantime, do your best to accept the reasoned, science based replies you have had in both threads, and stay relaxed as you wait for your negative test result -- which for sure is what you can expect.
---
29 months ago
Ok thank you Dr.
29 months ago
Dr I am uncircumcised and had unprotected anal sex with a woman I knew around 18-19 years ago. Does this change your thoughts? Obviously since then I have been in a monogamous relationship for around 16-17 years and had 2 kids. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
29 months ago
This doesn't change anything. The chance you have HIV is zero for all practical purposes. Your test will be negative.

That concludes this thread. Please note the policy above about repeated questions on the same topic, but I do hope this discussion has been helpful. 
---