[Question #7274] Sexual transmitted infection or other

5 months ago
Hi Doctors,

I asked a question recently (7258) but there has been a development. Exposure (unprotected oral, protected intercourse high risk person). I have a server white tongue, swollen lymph nodes in jawline (still 3 months) tiredness (still) , light headedness (still) and nausea. I also now have a low WBC but I am a young healthy person so must be because of infection. 

A person I live with now has the same symptoms as me. They used a needle to remove a splinter that I used before (sure they did but I wasn't in the room). A month after that, they have now have excess gas predominately burping, tiredness, lightheadness and nausea for a week. That person's partner is also tired all the time and felt like he was sick.

At 31 days I took a full screen with a 28 day window period. Accuracy as follows:
Syphilis: 99.7% = IgM & IgG by EIA
HIV: 99.8% = 4th gen 
HEP B&C: 99.9% = antibody & antigen 

I know they are very accurate but what is the chance it didn't detect it and ive passed it on!?

If its not that is there a chance I picked up something else and have transmitted it to them a different way? - like a virus but been to long surely? 

Do these symptoms sound like HIV. Syphilis or Hepatitis?

I am going for a 3 month confirmation on friday but riddled with anxiety and guilt. 

Please help

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
Welcome back, but sorry you round it necessary. I reviewed your recent discussion with Dr. Hook and agree with all he said.

I'm not sure what concers you, i.e "there has been a development". I see no information that would alter anything already discussed. Dr. Hook already reassured you about your apparently low WBC. But probably it's not really abnormal at all; if it were of concern, the clinic would have contacted you about it. That you have a coated tongue is irrelevant:  that's such a common, day-to-day occurrence that any one such event almost always is meaningless. Your negative tests prove you do not have the infections for which you were tested, and therefore that no symptoms you have now or in the future can be due to any of them, unless and until you have a new exposure. And by the way, the exposure you describe was zero risk for all these infections anyway.

I see no need for another test at 3 months, at least not from a medical or risk standpoint. However, you should go ahead as planned -- not because of any realistic chance of a positive result, but because many anxious persons are more reassured by negative test results than by professional opinion, no matter how expert. (We don't take it personally!)

Feel free to return and let me know the test results. But I won't have anything more to say until then.

HHH, MD
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5 months ago
Hi Dr HHH,

I apologise if my questions are irritating to you due to the minimal risk involved, but please accommodate me in answering this final question and I will leave you alone. 

I went to the GUM clinic today and will get my results next week (but that’s irrelevant). 

Question:

I take multivitamins everyday, which contain biotin 50ug and did on the day of the test. I have read a lot online that biotin can cause false negative results on a number of tests including hiv. It’s not lost on me that anxiety is affecting my ability to believe the tests, but could this affect my results regardless of the risk? 

Thank you.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
To the best of my knowledge, the buissiness about biotin interference with HIV tests is theoretical only, with no evidence of a real problem.

You have already had nearly conclusive test results and can expect another negative.
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
More about biotin and HIV testing. I contacted two nationally (US) recognized experts in the science and performance of the current HIV tests. One replied "I’m not aware of any concerns [about biotin and HIV testing] and definitely have not heard anything from" any HIV test manufacturers. The second agreed with that statement.

It's an urban myth. Pay no attention. Your test result will be conclusive.
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5 months ago
Hi Dr Handsfield,

I greatly appreciate the help you have offered and would like to thank you & Dr Hook for helping me through this time, anxiety clearly got the better of me. I got my three month test results and as you predicted they were all negative! 

I do still feel ill throughout the day and will follow up with my doctor about how to proceed (perhaps I picked up a bacteria or virus), but now I can accept conclusively that what ever is causing my discomfort its not STI related. 

All the Best! 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
5 months ago
I'm glad (but of course not surprised) for your negative repeat test. I doubt any bacteria or virus explains your contiuing symptoms. Probably emotional/psychological. I'm confident you have no infection of any kind from the sexual exposure described.

That concludes this thread. Please be aware that repeated questions on the same topic are discouraged, and when they continue are at risk for being deleted without reply (and without refund of the posting fee). ASHA is not keen on continuing to collect fees from anxious persons who are going to simply get the same advice repeated, and such questions have little educational value for other users, one of the goals of the forum. If you find yourself still worried, with a "yes but" or "could I be the exception" sort of concern, I would advise re-reading all three of your forum threads:  almost certainly anything else that comes to mind has already been addressed. Thanks for your understanding.

Thanks for the thanks. I do hope the discussions have been helpful!

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