[Question #6937] confusion HIV. PID, Lymph nodes

11 months ago
Dear Doctors, 

I am male 40 years old from an Arabian country I had exposure to HIV since 7 months ago in Belgium, one week after this exposure I started to have normal unprotected sex with my wife (40 years old) so after 3 weeks she started to feel pain in her pelvic, sore throat and pain in her breasts, both of the above pains are repeating almost every one or two weeks, last week she went to her doctor whom said that she has PID and gave her treatment for both of PID and vaginal yeast infraction, she started to feel better now. 

also one month after exposure I got swollen lymph nodes at the both sides of my groin confirmed by Ultrasound (largest one 1.91 cm likely reactive) also different doctors confirmed to me that I have also some under the jaw and the right side of my armpit (only the lymph nodes in the two side of the groin are still swollen). 

The problem that I am worried that I could be (seronegative) I mean that my body are not producing antibodies as since I was a child I am suffering from Allergic rhinitis, sinusitis, and stomach and colon infections/ inflammations. 

I did the following tests: 
- 45 days: HIV 1/2 ABAG, HCV repaid: all are negative. 
-84 days: HIV AB repaid: Negative. 
- 96 days: HIV AB, HCV AB, HBV AG: all are negative. 
- 15 weeks: PCR HIV1 qualitative, PCR HCV qualitative, PCR HBV qualitative: all are negative. 
-18 weeks: HIV 1/2 ABAG, HCV AB, HBV AG: all are negative. 
- 23 weeks: PCR HIV1 qualitative, PCR HCV qualitative, PCR HBV qualitative: all are negative. 
- 23 weeks: -18 weeks: HIV 1/2 ABAG: Negative. 

My questions are: 
1- Am I seronegative) I mean that my body are not producing antibodies as since I was a child I am suffering from Allergic rhinitis, sinusitis, and stomach and colon infections/ inflammations?
2- I think that my tests for HIV-1 are conclusive? but what about HIV-2 in case of my body isn't produce antibodies and please note that HIV-2 PCR is not available in my country? 
3- do I need to retest for HIV?
4- does my wife need to

11 months ago
5- are my wife symptoms related to HIV (PID, Vaginal Yeast infraction and pain in her breasts)? 
6- are my tow side swollen lymph nodes in groin are since 7 months and still are related to HIV? 
7- do you recommend us to test for any STD? 
Edward W. Hook M.D.
Edward W. Hook M.D.
11 months ago
Welcome to our forum. Thanks for your question. I’ll be happy to comment, both on the diagnosis of PID in your wife and it’s management, as well as the possibility That you might have acquired HIV through the encounter you described.

1.  PID first.  PID occurs when bacteria from the vagina and lower genital track travel from the lower genital track of a woman up into her uterus and pelvic organs. PID is sometimes caused by STI’s such as gonorrhea and chlamydia but may also be caused by normal vaginal bacteria which happened to travel upward in the genital tract.  The most common symptoms of PID are lower abdominal pain and, sometimes, unusual discomfort during sexual intercourse. Common practice is to treat sexual partners of women with PID using the same antibiotics that the woman has received. Was your wife tested for STI’s? Were you? Some infections such as gonorrhea and chlamydia can occasionally occur without symptoms in men and the spread to cause PID. Did you take antibiotics?

2.   HIV.  I am confident that you do not have HIV. Your tests prove this conclusively. Tests any time after 42 days are conclusive. The tests you have had include not only tests for antibodies to the HIV virus but also to the virus itself ( both the PCR test and the antigen of the fourth generation test) test for the presence of the virus.

Thus, in answer to your specific questions:
1.  No, as explained above, you have been tested not only for antibodies but also for the virus itself. believe your test results.
2.  Yes, your results are conclusive. The antibody tests that you have had would also detect HIV-2.
3.  No, your results are conclusive.
4.  No.
5.  No, although her PID could be related to an asymptomatic STI. If you have not had a urine test for chlamydia and gonorrhea, I would recommend it. 
6.  No, swollen lymph nodes are a non-specific findings and if your HIV test is negative you can be confident that your swollen lymph nodes are not due to HIV. They could be a nonspecific reaction to any number of other non-NSTI viral infections such as CMV.
7.  If your wife has received antibiotics I do not think she necessarily needs testing for STI’s. On the other hand, if you have not received antibiotics I think it would be a good idea for you to have tests for gonorrhea and chlamydia as suggested above.

I hope that this information is helpful to you. If anything is not clear or if you wish to reply to any of the questions I am asking this response, please use your up to two follow-up questions for that purpose. EWH
11 months ago
Dear Dr. Hook , 
thank you very much for your reply, 

1) Yes my wife is taking Clindamaycin 300 mg for PID and she started to feel better now (after almost 05 days from the tratment), also I am taking Macrofuran 100 mg (Nitrofurantoin macrocrystals), should I test for gonorrhea and chlamydia.

2) I want to have your clarification if I am one of the people whom their bodies  not producing antibodies as since I was a child I am suffering from Allergic rhinitis, sinusitis, and stomach and colon infections/ inflammations because at this case of course I had received a false negative HIV-2 antibody test?

thank you for your help. 
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago

1.  You should probably be tested for STIs, specifically gonorrhea and chlamydia.  This can be done with a urine test.

2.  If you did not produce antibodies you would have likely died long before reaching adulthood.  Further, as I explained above, since you were tested not only for antibodies but for the virus itself, you can be entirely confident that you did not acquire HIV.  No change in my assessment.  Allergic rhinitis, sinusitis and stomach infections are not worrisome to suggest that you d o not produce antibodies. 

I once again, urge you to believe your test results.  EWH

10 months ago
Dear Dr. Hook, 
thank you very much for your information. 

As I know that it will be the last reply from your side, I want to share you with some important details regarding my exposure, actually it was 2 exposures,

The recent exposure  was 7 months ago as a protect oral & vaginal sex with CSW in Belgium but I felt that  the wire of her loop (IUCD)  has been pricked my penis but the condom didn't break.

The first exposure was since 6 years ago which was a very fast anal sex with CSW .

my questions are: 
 1- it is possible that the wire of IUCD pricks my penis through a small hall without breaking the condom? 

2- is the above  IUCD's wire pricking could transmit the HIV virus to me? how much percent the possibility for this scenario? 

3- As I expanded to you before, my wife doctor said that my wife has PID, but he give her treatment for both of Vaginal Yeast infraction and PID but acutely my wife has no discharge, is it possible that she has a Vaginal yeast infraction without discharge or the treatment of PID should include also a treatment for Vaginal Yeast infraction? 

4- My wife Doctor said, that the reason of her PID is using the vaginal washers, is it possible? is this the reason that he did't advise me to take the same antibiotic? 

5- regarding my swollen lymph nodes (in two side of the groin), please note that these had confirmed by Ultrasound but the it is painless,  are usually HIV Swollen lymph nodes in the groin painful or painless? 

6- is HIV-2 causes swollen lymph nodes? 

7- I read that PID and Vaginal Yeast are symptoms for HIV? at which stage? 

8- do you think that I got infeacted with HIV-2 since 6 years so my wife is on AIDS stage now? 

9- Is my recent exposure (07 months ago with condom) could transmit to me gonorrhea or chlamydia but not HIV? 

10- I read an answer to you in this forum to a gentleman form India regarding HIV-2 whom had been informed from his doctor that he has to test on 6 months for hiv-2 after his last test on 82 days, and you side that it is very fare scenario but you advised him that he can do this, my last hiv 1/2 ABAG was on 161 days? should I repeat my test of 180 days? I didn't test PCR for HIV-2 only HIV-1 PCR?  is there any difference for HIV-2 between 161 days & 180 days? 

11- if my wife recovered due to her current treatment, does this mean that it was't neither  gonorrhea not chlamydia?

thanks for your important information. 

Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
Welcome back to the Forum and thanks for the additional information.  It in no way changes my assessment that you do not have HIV but it does help with the assessment of your wife’s PID.  I will respond to your questions in order:

1.  No, your partner’s IUD would not make a hole in the condom without the condom breaking wide open. Be confident that the condom worked.
2.  The situation you described has never been described before. I would not worry that the string on your partner’s IUD changed your risk for HIV in anyway. Furthermore, your testS proved that you do not have HIV.
3. I cannot explain for certain why your wife’s doctor chose to treat her with both antibiotics and medications for yeast. It may be that when a woman takes powerful antibiotics, she is at increased risk for developing yeast and that some doctors give preventative use treatment at the same time along with the antibiotics.
4.  Please vaginal washing (douching) can increase the risk of a woman for developing PID. In such a case you would not need treatment.
5.  Please don’t worry about HIV. You have proven that you do not have it. When HIV causes swollen lymph nodes however the song is typically painless.
6.  Yes, but you have proven that you do not have HIV.
7.  This is incorrect.   I suspect that the internet has misled you.
8.  No.  As I said, you have proven that you do not have HIV.
9.  HIV, Gonorrhea and chlamydia can be transmitted separately.
10.  I see no Medical or scientific need for you to test again.  Believe your test results.
11.  It certainly makes it far less likely.

I hope this information has been helpful to you. As you know this thread will now be closed without further responses. I trust that you will not need to return to our forum with additional questions. I urge you to believe your test results and move forward without concern. EWH