[Question #5446] Negative test with chronic symptoms

22 months ago

Hi Dr.’s,

 

Thanks for your service. I am a married man who had an unfaithful experience back in November of 2017. Guilt overcame me a few weeks later and I began to panic and get tested. I tested negative with a 5th (?) generation at 19 days and a negative RNA at 26 days. I then had another negative 4th generation at 36 days and negative full panel via labcorp at 90 days. The only ‘symptom’ I had at the time was a few lymph nodes I could feel in the back of my neck, 4 on one side and 2 on the other, that all dr’s declared ordinary.

 

The exposure was not much. Mutual mast. with fluid exchange. My fear was that I shaved my region that morning and cut it up a lot and then this happened later that night. She also digitally entered me for a minute or so so I’m concerned her fluids may have been on her fingers and she cut me.

 

Either way – I was mostly over it but it stayed on my mind for awhile, so much so that I eventually told my wife and we separated for a few months. Thinking it was over, at a bachelor party I received oral from a woman at a bar who was married. I digitally entered her as well. Anyway, a month or so later my wife and I reconciled so in December of 2018 (5 months after second incident)I submitted for another hiv test and ghon/chlam and everything was negative. My wife then this march bought life insurance and thus was tested for hiv and was negative.

 

I recently had a scare because my daughter was sick and I thought she had thrush as she had a white tongue. Just a film though and it went away so I figure it was not thrush (shes 5 so not in age range for it. But this triggered paranoia. I found this site and saw your post from a few weeks ago talking about symptoms of chronic…and realized I might have 2. Ever since this January I have suffered from both loose stool (not diahreeah but a definite change in consistency, much looser than normal) as well as off and on dry/raw skin on the sides of nose and under eyes. I did not put much thought into that as it was over the winter but also had some red spots around bridge of nose under eyebrows. Moisturizer cleared it up. However I saw your post indicating that seb. Dermatitis can be an early sign and I read in many people it can THE presenting sign so that began more panic. Is this consistent with HIV if I acquired it November 2017 or july 2018?


Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
Welcome to our Forum.  I'll be glad to comment.  The short answer is that the exposures you describe did not put you at risk for HIV and  that your tests have proven that you did not acquire HIV.  You can be confident that your daughter's recent illness and your own symptoms are not due to HIV acquired through the exposures you described.  To provide more detail-

I suspect none of your partners had HIV.  Most women do not.  Even if they did-

Your 2017 encounter did not put you at risk for HIV.  Engaging in mutual masturbation, even when it includes insertion of fingers which may be contaminated with a partner's genital secretions, are safe sex which are not associated with risk for HIV acquisition.  It is typical for persons engaged in mutual masturbation to get each others' genital secretions on one another yet no cases of HIV transmission have occurred from this sort of contact.  Similarly,no one has ever acquired HIV from receipt of oral sex so you are in the clear from your December 2018 encounter as well.  

As an FYI, the symptoms you describe at various places in your post are non-specific. Lymph node swelling is a totally non-specific reaction to inflammation.  Similarly, there are many potential causes for loose stool.  As for thrush, HIV is just one cause of thrush and most persons with thrush do not have HIV.  Likewise for seborrheic dermatitis - most persons with seborrhea do not have HIV.  When persons have symptoms of HIV and their HIV tests are negative, the tests should always be believed as the symptoms are non-specific as noted above. 

I hope these replies are helpful to you.  I see no reason for concern from what you have written and would be confident that you do not have HIV.  EWH 
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22 months ago

Hi Doc. Thanks for the quick reply. I won't hold you to keeping up that pace.

A few other points...I bled a good amount in the November 2017 incident the morning of from shaving. It happened later that evening so significant time passed, at least 5 hours, but still I had some open bleeding in the shower that morning...so was concerned about her fluids in the pubic region with cuts.

Also - I wasn't diagnosed with Seb Derm and moisturizer clears it up for some time but then it comes back. It's mostly raw red skin on sides of nose which flakes sometimes and at the sides of the bridge of my nose...just red spots. Happened a lot over the winter but now even in summer months it still happens, mostly after the shower. Does it present a certain way with HIV?

Thanks for the note on thrush. It was about my daughters white tongue when she got over a nasty URI. Assume there's no reasonable way I could have passed it to my daughter even say sharing an apple or if I ever had a cut get on her (shes a thumb sucker, so worst case scenario could be her sucking her thumb with something of mine on it.)

Another ? my wife unbeknownst to her at a regularly scheduled gyno appt. had a urine culture for bacteria. It showed no growth. The dr. told her if she had chlym/ghon it would show there, is that true? It doesn't say it tests for it on the paper.

Lastly, the reason I had so many tests in the first place was because I took a hair loss supplement up to the 90 day test. It didn't show biotin in it but I guess they don't always list all ingredients? I read about biotin interference (link below) so made sure I wasn't taking anything when I took my last 4th gen test from my regular dr. (12 months from first exposure and 6 months from second). https://www.healthcare.uiowa.edu/path_handbook/Appendix/Chem/BiotinImmunoassayTables.pdf

To recap:

1. recent moderate bleeding

2. Seb. Derm presentation in early HIV

3. Daughter risk

4. urine culture

5. interference/test accuracy

Thank you!


Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
thanks for the additional information.  It does not change my assessment however:

recent cuts, even when contaminated with genital secretions are not a risk factor for HIV.

Seborrheic dermatitis is sometimes more sever in persons with HIV.  As I said, most persons with seborrhea to not have HIV and you have negative tests which ALWAYS trump any symptoms.

You could not have infected your daughter, first because you do not have HIV and secondly, HIV is not transmitted by sharing food, eating or drinking with the same implements or kissing.  

Urine can certainly be tested for gonorrhea and chlamydia provided the test is ordered.  An every day urine culture or urinalysis does not check for gonorrhea or chlamydia.  

There are no supplements, including biotin which interfere with HIV test results.  Believe your tests

Please don't worry.  EWH
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22 months ago

Thanks Dr.

1. Any idea why the Iowa.edu link I provided shows a decrease with biotin on a sandwich assay then? I'm certainly not intending to challenge you and I trust you over them, just curious if you can offer any insight to that. Also - hopefully if this is something that comes up occasionally it can help people in the future who search biotin on this site as I've seen it come up in other forums

2. The test my wife got which she said would have detected one of the std's mentioned reads 'microbiology - urine culture, no growth'. I think what her obg told her was that ghon/chlym growth would show there? I ask because she's had slight bleeding occasionally during s exual activity (no pain or any other symptoms). My tests 6 months after the fact for those were also negative...is it possible to test too long after the fact?

3. Sorry about the seb. derm questions. I just never had dry skin on my face before...so this seems like really bizarre timing to get it a year and a half after the fact. I know you're not a dermatologist, just hard to look past that and the loose stool. But I have a physical approaching so I'll discuss with my gp. Dr. Handsfield mentioned a few weeks ago that this is seen in about 50% of hiv pos people within 5 years. BUT he said it was excessive dandruff especially when extending to the face. Assuming you agree, is me just having patches near nose and eyebrows not even in line with that?

4. Just please confirm with the 2 exposures ive been sufficiently tested. Exposure 1: 4th gen 19, 36, 90 days. RNA 26 days. 4th gen 367 days (does 4th gen too long after ever go negative?). 2nd exposure: 4th gen 6 months after, ghon/chlym of urine and throat also 6 months later.

Sorry for all these comments. I guess I want to get my moneys worth. I just love my children deeply and can't stand a scenario where I get them sick and/or have a situation which causes my wife to leave me and I lose them every day. I'm done screwing up on that end, I just want to make sure nothing (like being positive with something) comes back to bite me. Thank you.

22 months ago

Oh and last last question! Sorry. Happy I remembered though.

Let's call this # 5. My wife's obg did a very extensive blood work for really no reason. Her GP was annoyed by this and said it was unnecessary. Anyway - granted while she tested neg for hiv the same time for life insurance (4th gen siemens) the only abnormal finding from her blood work was high amylase and lipase. Amylase was only 101 and normal variant stopped at 100, so that wasn't a big deal. But her lipase was 149 and normal variant was 13-60. This had us in a panic...and me secretly panicking because I read that hiv positive people have higher lipase readings. Anyway, because she wasn't expecting to have this cbc done by her obg she ate an egg sandwich prior. Her GP told her food could throw the test off and retested her and her levels were within normal range (high side of normal but still the labs normal range). Any concern here? Told you I'd get moneys worth. I would have been kicking myself if I forgot this. Thank you.

Edward W. Hook M.D.
Edward W. Hook M.D.
22 months ago
It sounds to me like you are overthinking this.  Final responses:
1.  Biotin.  You do not know that the supplement you took even had biotin in it and certainly if there were large amounts, as suggested were necessary in the link you found, it would have been mentioned.  This increase only said their was a potential effect.  There are no scientific studies to suggest this is a problem.
2.  As I said above, a standard urine culture which, from your post this appears to have been, would not have detected gonorrhea of chlamydia.
3.  I agree
4.  You were sufficiently tested
5.  Your wife's transient increase in amylase does not suggest HIV.

My sense is that your guilt and anxiety are not serving you well.  I suggest you stay of the internet as much of what is there is taken out of context, out of date or just plain wrong.  Deal with your guilt, forget about the possibility that you have HIV or an STI- you don't.  

End of thread.  EWH
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22 months ago
I know we're closing thread but just want to quickly stat her Lipase was very high, basically 3 times normal level. But that was right after eating...when fasting it was within normal levels. You mentioned slight amalyse so just wanted to be clear. Thanks for everything