Hi Doctor, Thank for the precious service you are providing to tormented soul like mine.

I had protected sex with a female, but cunnilingus was not protected, days after the act dentist confirms my gum is bleeding. 3 weeks after I develop mild sore throat that last 4 weeks. 5 weeks after I get a posterior cervical lymph node (diagnosed via ultra sound as non specific lymph node)

I tested HIV negative at 5 week via blood taken from vein. From 5 week to 13 week I had a bunch of symptoms (night sweats, burning and tingling sensation body wide, bilateral ulnar nerve entrapment, body wide fasciculation). I Tested at 92 days 5th gen Ag/Ab HIV Negative, I was happy and ready to move and promise to never put myself in such a predicament.

Now I still get fasciculation body wide, at 20 weeks post exposure I develop dry mouth and white tongue till now, what is making me very scared is the white patch on the lateral side of my tongue and on the internet they said it is oral hairy leukoplakia and it is due to EBV which is strongly linked to HIV.I saw a ORL he confirms the white patch on my inner cheeks are leukoplakia, he does not seems to concern since I had two tests. I had a CBC 3 weeks ago my neutrophils ANC is at 1.4 which is low, I had one 3 months ago it was at 2.

FYI at 4 weeks post exposure I tested negative for (Syphilis, Chlamydia, Gonorrhea, hepatitis B), CMV IGG reactive but IGM non-reactive. I had an EBV test IGM was negative test, but they did not mention anything for IGG, it seems it was not requested.

1- Can you assess my risk? I am very scared of the white patch on the side of my tongue

2- the female tested 13 days after the act for STDs and HIV and she was negative, but she is promiscuous and been with at least 3 different guy in less than 3 month before the exposure

3- The duo test was performed at the same lab, I am scared they were not able to detect HIV

4- I used a topical Steroid HydroCortisone valerate 0.2% 15g for a moderate psoriasis during the three months of the test, do you think that could affect the result?

5- What is the association of HIV and low neutrophils? do you think a neutrophils ANC 1.4 is a sign of a weak immune system? I am feeling healthy aside of my dry mouth and tongue issue

Welcome to the Forum.  I'll do my best to help.  It is clear from your post that you regret the encounter that you describe which occurred more than three moths ago.  I understand that but I can completely assure you that you did not acquire HIV or any other STI from that encounter.  Your tests prove this.  If your symptoms are troubling you other than in the context of your anxiety and concern over your misstep, then I recommend that you work with your own doctor to determine what the cause might be- it is not HIV.  In answer to your specific questions:

1- Can you assess my risk? I am very scared of the white patch on the side of my tongue.

Your risk was negligible.  Condom protected genital sex is safe sex and to my knowledge, there are no proven cases in which someone has acquired HIV from unprotected cunnilingus.  The testing she had proves that she was not infected and your own tests prove that you are not infected.  The white patch you describe is due to something other than HIV.

2- the female tested 13 days after the act for STDs and HIV and she was negative, but she is promiscuous and been with at least 3 different guy in less than 3 month before the exposure

See my comment above.  Her negative tests prove that she could not have infected you.

3- The duo test was performed at the same lab, I am scared they were not able to detect HIV

The tests are highly reliably.  The lab is a good lab or LabCorp would not have bought them.  Believe your results.

4- I used a topical Steroid HydroCortisone valerate 0.2% 15g for a moderate psoriasis during the three months of the test, do you think that could affect the result?

No

5- What is the association of HIV and low neutrophils? do you think a neutrophils ANC 1.4 is a sign of a weak immune system? I am feeling healthy aside of my dry mouth and tongue issue

This is a low normal ANC and should not concern you.  It does NOT suggest HIV.

6.  There is no reason whatsoever for further testing. 

I hope that these answers are helpful to you.  My sense is that you have been on the internet.  Please do not look for answers there as much of what is there is misleading.  EWH

Your follow-up questions in large part validate my impression that you are being misled by your internet searches.  None of them in any way change my assessment- your exposure was virtually no risk and that FACT has been validated by your test results.  I urge you to get over this and move on!  My replies to your internet fueled questions will be brief:

1.  This sort of "what if" question is unrealistic.  At 14 days her 4th generation test would have detected well over 50% of acute infections.  Remember, she had gotten this far without being infected.  The chance that she was in the window is much low than your chance of being hit by a meteorite falling from the sky.

2.  the statement you refer to in categorically incorrect and has been posted by someone who has a conflict of internet.  Ignore it.

3.  The CDC often uses statements like "in rare occasions" to make sure that they are never wrong.  While theoretically possible, from a practical standpoint there is no reason to worry about a 2nd window.

4.  Wrong!!!!  Most people with cervical lymphadenopathy, as well as hairy leukoplakia do not have HIV.  You are being misled by the internet.  Believe your test results not some internet myth!

5.  I have never seen or heard of anyone acquiring HIV from cunnilingus.  This is another "what if" question.  Believe your test results!!

I apologize is my response sound brusque but the questions you ask are sterling examples in internet generated paranoia which lead to all too much anxiety and concern.  I urge you to believe your test results and move forward.  If you have symptoms which concern you (like your possible hairy leukoplakia, instead of allowing the internet to amplify your unwarranted paranoia.  EWH

Thank you for your thanks.  You really must stay off the internet and believe your tests.  In answer to your follow-up, somewhat repetitive questions (Einstein once said that to do the same thing again and again and expect different results is the definition of insanity.  My assessment is not going to change: