[Question #6979] Follow up Question #6937

8 months ago
Dear Doctors, 

Thank you for your help and I am sorry to back again by my anxiety become huge, following to my first question # 6937, I want to share the followings facts as I know that  100% I didn't infected by HIV-1 but all of my concern is belongs to HIV-2 which I know that is very rate but please note that even after I did all the followings tests: 
45 days: HIV 1/2 ABAG, HCV repaid: all are negative. 
-84 days: HIV1/2 AB repaid: Negative. 
- 96 days: HIV1/2 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: -HIV 1/2 ABAG: Negative. 

I am still very worried because HIV-2 test is for Antibody only not for antigen as well as there is no PCR available for my country for HIV-2 while I have the following problems
-Since 7 years until today, on daily basis I am using for my Allergic rhinitis many of  Corticosteriods medicines which are Nasonex Spray,  Zyrtec and Clearst which I read that this effected negatively on producing HIV-2 antibody once I taking them for long term.  
- Since 10 years, I am taking on daily basis Omega 3 Fish Oil. 
- I had made to CBC, the first one on 20.01.2020 while I have Low Lymphocytes on 1295 with total white Cells of 6300  and the second one on 15.03.2020 (on the same day of my 23th week tests) which was 1745 with total white cells on 5300 so after two months the total White Cells went down while the Lymphocytes count went up!! 
- Still my Groin lymph nodes in the two sides are swollen onfirmed by Ultrasound (largest one 1.91 cm likely reactive), sometimes I had some under the jaw but the doctor said that these are very small and likely due to inflammations. 
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.

8 months ago
Sorry, I will continue. 
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.
- 04 days ago, I started to have Oral Thrush (Yeast infection), I know that I am sure out of ARS as I am almost 8 months now but once I didn't produce antibody yet may be I start to have a very low CD4 count, I started to use Betadine mouthwash, I start to fell better but I also use Toothbrush to wipe the white color, which has become very thin, but this does not result any bleeding or pain. 
my questions regarding HIV-2 concern are: 
1. Do Corticosteriods medicines  I am using since 7 years which are Nasonex Spray,  Zyrtec and Clearst will effected negatively on producing HIV-2?
2. Does Fish OIL Omega 2 will effect on my HIV-2 test result? 
3. what my two test results for  White cells total count and Lymphcyts count indicate ? Do I have a normal immune system? 
4. as my second CBC test with a higher lymphcyte count (1745) I did on the same day of my 23th week tests prove that my immune system is doing normal and I should produce antibody? 
5. Sorry again, 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/ inflammation? 
6.  I have Oral Thrush symptoms after 8 months? White tongue which start to be better after 3 days from using Betadine Mouthwash and the toothbrush to wipe the white color, which become very thin, but this wiping does not result any bleeding or pain? 
7- Regarding my Swollen groin lymph nodes in the two sides confirmed by Ultrasound (largest one 1.91 cm likely reactive) I had after 01 month from the exposure, I want to know how common to have only Swollen lymph nodes as ARS as I didn't have anything else? 
8- is there any relationship between the swollen lymph nodes and producing the antibody? I mean that sure I have produced antibody once I have swollen lymph nodes? so if the swollen  lymph nodes are cause of HIV-2 so the antibody test should be positive, please clarify? 
9- In total of all the above, should I repeat my test? if yes after how many days from stopping Corticosteriods medicines and Fish OIL I should retest?
10- In case of HIV-2 positive? what the situation will be? is the treatment really effective? what about the side effect how many years 41 years old guy expected to live? 
Sorry for my long message but please consider than I am House father of a family including a wife and 2 beautiful daughters whom are still need care?  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
Welcome back, but I'm sorry you found it necessary.

I'm not going to go into any detail on the same questions Dr. Hook answered recently. 

You are way overthinking everyting. The HIV blood tests you had are conclusive for HIV2 when done more than 6-8 weeks or more after the last possible exposure (and for sure when done after 3 months or more). Test results always overrule symptoms; even if you had typical HIV symptoms (you do not!), the test resutls prove HIV (either type) is NOT the cause. And there are NO medications, vitamins, diet, lifestyle issues, or medical conditions that interfere with the accuracy of the HIV tests you have had. That's an urban myth left over from the earliest HIV blood tests that have not been done in over 20 years. Extremely brief replies to your specific questions:

1) No.
2) No.
3,4) White blood cell counts do not say anything much about the immune system one way or the other. But your results are normal. Everybody's WBC counts vary from day to day in the way your have done. 
5) The only medical conditions that prevent antibody development make people deathly ill starting in childhood and most do not survive beyond age 20. Since you have been outwardly healthy, you can be sure you make antibody just fine.
6) First, oral thrush needs medical diagnosis. Self diagnosis is highly unreliable. And oral thrush sometimes occurs in entirely healthy people and is not a sign of immune deficienty.
7,8) Occasional enlarged lymph nodes are quite common. If the problem persists, keep working with your doctor to learn the cause. It is not HIV.
9) You should not have any more HIV tests of any kind.
10) You don't have HIV2, so this question is irrelevant. In general, people with HIV2 are less severely affected than those with HIV1.

I'm glad to hear you have a lovely family. Do your best to stop worrying about them on account of a sexual decision you regret. You do not have HIV of either type. Believe it and move on. If you cannot, I strongly recommend professional mental health counseling. It is not normal to remain so upset and unconvinced in the face of the repeated, reasoned, science-based reassurance you have had both on this forum and probably from your own doctors. All this is a psychological reaction, not medical.

Let me know if anything isn't clear -- except DO NOT ask ANYTHING that has already been addressed in these comments or Dr. Hook's replies a couple of weeks ago. Thank you.

HHH, MD
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8 months ago
Dear Dr. Handsfiled,
Thank you for your help. 

I Just I want clarify from you your answer on the same inquiry had been asked here before regarding corticosteroids as you had said"  It's simply a non-problem, for HIV testing or any other antibody testing, at least at the doses and durations of treatment used 99% of the time." As i I am taking Nasonex twice per day since 7 years is this too much use for corticosteroids could affect the antibody test of HIV2?
8 months ago
Also I want to clarify from you Sir,  how much accurate the information that HIV2 is much less transmitted comparing with HIV1?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
No corticosteroids have any effect on HIV test reliabiliy, even at the very highest doses used. Even the 99% figuure I used above assume antibody testing only, but you had antigen and DNA testing as well. With those tests, steroids have NO EFFECT AT ALL -- it's an urban myth. And Nasonex doesn't even get into the blood!  Its has no possible effect.

Yes, HIV2 is less readily transmitted than HIV1, but not by very much.
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8 months ago
Dear dr. Handsfield,
Really I am very much appreciated for your helpful answers to me.
As this it will be the last reply, i want to get clarification from you regarding some of your answers also to add few information.

1. Reference to yiur lasr reply to me, I want to clarify that I didn't have any HIV2 PCR test, it was only for HIV1, so I am counting on my HIV2 antibodies tests as negative results I had, so please confirm to me if I understood correctly that all of the long term medicines including nasal corticosteroids, antihistamines, Contrloc 40 and coloverin- D or coloverin-A (All of them together on daily basis since about 07 years) didn't effect at my hiv2 antibodies tests result?
2. I also took 2 Antidepressants and antidepressants which were Quitpaex 25 + Fluvoxamine maleate 50 once perday from each for 5 days only and stopped them 2 weeks before my last tests (23th week tests) do these medicines can effect my test result for HIV2 antibodies?
3. As Dr. Hook answered to me that if I have swollen lymph nodes (which are still swollen) cause of HIV your test should be negative, does this rule also valid for HIV2 antibodies as well, i mean that the swollen lymph nodes are related to producing the antibodies?

Now, I have to thank both of and Dr. Hook for all of your help and waiting to your vital reply which i am counting to forget this story completely and move on my life.

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
8 months ago
1. I knew all this.  A negative antibody test alone is conclusive evidence against HIV2 if done sufficiently long (a few weeks) after the last possible exposure.  I'm not going to repeat what I have already written. (Did you think I might have changed my mind? Or that I mis-wrote my previous replies?)  

2. What exactly did you not understand about "...there are NO medications, vitamins, diet, lifestyle issues, or medical conditions that interfere with the accuracy of the HIV tests you have had"???

3. Symptoms don't matter, whether lymph node swelling or anything else. Your blood test results prove that these and any other symptoms you have now or develop in the future are not due to HIV, assuming no future exposures.

That completes the two follow-up exchanges included with each question and so ends this thread. Please note that the forum does not permit repeated questions on the same topic or exposure. This being your second, with identical opinions and advice each time, it must be your last. Future new questions about these issues will be deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is designed to reduce temptations to keep paying for questions with obvious answers. In addition, our experience is that continued answers to anxiety-driven questions simply prolong those anxieties, when a better option is usually to seek professional counseling. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thank you for your understanding.

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