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Dr. Andrew Rynne

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Had unprotected sex. Got night sweats, diarrhea and body ache. Tested positive for elisa. What to do?

Answered by
Dr. Chakravarthy Mazumdar

General & Family Physician

Practicing since :2004

Answered : 1779 Questions

Posted on Sat, 22 Dec 2012 in HIV and AIDS
Question: I am a 37 year old man from Norway. 6-8 years ago I had two incidents of sexual contact with West-African prostitutes. My fingers (with open sores) were in contact with the girls vagina. I might have had a seroconversion disease several years ago, but since I didn't know anything about HIV symptoms then I didn't relate it to the incidents.

In September 2011 I got diarrhea that lasted for 3 months (still have it on and off). 2-3 week after the diarrhea startet I got a fever-like feeling in my head (no fever), lasted for 8-9 weeks. At the same time I also got extreme night sweats. During this period of about 3 months I also experienced extreme fatigue, extreme sound sensivity, very high resting heart rate (80-90), one incident of fungal infection in my mouth, excess mucus in my lungs, 10% weight loss, body aches, dry mouth, muscle twitches, sore throat. I tested positive for Mycoplasma pneumoniae in addition to Streptococcus in October 2011.

I still experience varying degrees of tiredness/nightsweats/diarrhea/body aches and the fever-like feeling in my head is back since beginning of September. Recently my skin started to become very itchy. Despite negative HIV-tests I have persuaded three different doctors to check my CD4/CD8-levels.

January: 603/558 (ratio=1.08)
April: 753/1084 (ratio=0.69)
August: 704/937 (ratio=0.75)

It seems like I have an unusual low CD4/CD8 ratio. A CD8 count of 1084 is also outside the reference intervals (200-1000). I have increased levels of IgA and IgG, specifically IgG4 which was 3.66 g/l in january.

HIV-testing is telling me I am negative, 6 times the past year (combo test for HIV-1/HIV-2, antibody/antigen). ELISA-test in April turned out positive. Syphilis and Borrelia is negative. Should I
perform Western Blot and HIV RNA PCR tests for HIV/Hepatitis?

Is the HIV antibody test reliable also for HIV-2? Any other suggestion what this can be or what I can do?
Answered by Dr. Chakravarthy Mazumdar 6 hours later

In my opinion you had enough of testing for HIV negativity. So you do need further testing for HIV unless you stopped the high risk sexual behaviour.

You do not need Western Blot or HIV/Hep tests as well. HIV antibody test is reliable. Be rest assured that you currently do not have detectable levels of HIV virus. The CD counts are good. You should be worried if the CD counts are below 500, so should not conern you.

Coming to your symptoms they may not be related to the HIV or AIDS complex perse. They need a different way of looking by the physician near your area.

You are unnecessarily stress out, a acute on chronic stress disorder can mimic the above symptoms.

Let me know if I need to address your further concerns.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Chakravarthy Mazumdar 35 minutes later
I had night sweats, diarreah and feeling of fever in my head for 2-4 weeks before I even got the idea it could be HIV. That's why I am convinced it is a physical disease and not only symptoms due to mental disorder/stress/anxiety. Since I also have a positive ELISA test and an elevated CD8 count, I am even more certain this is a physical disease.

I lack other good diagnose theories that can explain my condition. I would be happy to receive some if you have any. I have tried Zyprexa and Cipralex with no effect on my symptoms.

Is it completely desperate to travel to London to take PCR tests at a private hospital? They refuse to perform these tests here in Norway, only public hospitals here.
Answered by Dr. Chakravarthy Mazumdar 6 hours later
Do you still have these symptoms? I mean you were reporting them during September 2011 and lasted for a month.

Since the ELISA was positive at one instance, you can retest it again now. IF positive then you can get the Western Blot confirm this. If repeat ELISA is negative you can start pursuing other diagnoses as well. There is no point in taking PCR test straight away, better is repeat ELISA. PCR is done at private hospitals and may not be available at public hospitals as it is involves cost and not under public health testing programme.

There are few other conditions which can cause similar symptoms like giardiasis, nutritional deficiency conditions. Ask your GP if he can rule out these conditions as well.

All the best.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Chakravarthy Mazumdar 9 hours later
If my symptoms had disappeared after one month I wouldn't be concerned.

I have had consistent night sweats for 14 months now. Diarrhea was bad the first three months, since then i have had diarrhea about 50% of the time. Consistent pain in my body since October 2011. Fever-like feeling in my head in October-November 2011 and this is now back since September this year. I also currently experience tiredness, itching, sound sensitivity and more. In September-November last year I also had a lot of other symptoms as I mentioned.

My doctor has told me he won't take more tests on me for 6 months, so I'm stuck with my disease. They believe it is hypocondria.
Answered by Dr. Chakravarthy Mazumdar 19 minutes later

The on and off symptoms definitely do not consist of the hiv/253657?iL=true" >AIDS complex. IF you were to be infected with HIV by now you would have got AIDS complex, since you are not you do not have AIDS complex. They are consistently constant unlike your complaints. This assurance should relax you. So reading it try to loosen your stressed muscles. Relax, take three XXXXXXX breaths in and out. Very slowly. See the things which are bright around you. You are just alright and needs a good expert to counsel. Probably I am the one sitting online with you to do that. I will do my best.

If you think testing and seeing is believing you may be wrong. But if you still insist you may go ahead further with PCR / Western Blot.

Now just think of an organism which is not seen to the naked eye is taking joyful life out of you. Do you actually want it to? No definitely not. You should take deroute to your goals and start living peacefully. You need to be tested for the above conditions mentioned by me in the above mail.

Suppose you start trusting your current doctor who says you are just presuming to be sick and follow his advice. I am sure you would not be doing anything wrong. Is it not? Then all you got to do is expert counseling with Psychotherapist. Of course you need medication to stop the symptoms as well. Believe not that every ill has a pill, so yogic practises, relaxation, biofeedback from experts is all the way.

Thank you.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Chakravarthy Mazumdar 4 days later
"IF you were to be infected with HIV by now you would have got AIDS complex, since you are not you do not have AIDS complex XXXXXXX

How can you be sure about this?

I have done some investigation regarding the time of the incident when I could possibly have been infected with HIV. It was XXXXXXX 2006. A few days after the incident I was seeing my doctor because I suddenly discovered that I had expanded blood vessels on my right arm/shoulder/chest muscle. I still have that. Can that have anything to do with HIV?

I would like to keep in touch with you to talk more about this case. I was pleased with you last answer which was kindof a relief to me. However, for the past few days my condition has gotten worse. I am having problems with sleeping now, and it is also remarkably uncomfortable for me to sleep/wake up these days. It has been like that for the past year, but now it is just as bad as it was last year when I first got sick. I also have a really dry mouth again at night, haven't had that since december last year. I have also experienced dry/burning lips the past few days, and have been thinking that it is an outburst of herpes. I haven't really had anything like that before as I can remember.

Also, the day before I wrote to you the first time, I asked my doctor for a referral to take PCR tests for HIV in London. I have now recieved the referral (to my big surprise) and I intend to go to London next week to perform these tests.

If nothing is found in these tests, I would have to start dealing with this problem in a completely different manner. I would like you to help me with that if you will be willing to help.

Answered by Dr. Chakravarthy Mazumdar 19 hours later
Hi, I definitely would help you to any extent. The science of medicine had taught me more than being doctor and human, i.e humane and help anyone who needs me. Be assured about that part.

The myriad of symptoms complained by you were not frequent in hiv/253657?iL=true" >AIDS complex. Hence I do not want to think of HIV / AIDS. I wish my patients to think like me when they suffer for so long. I would advise the same to you.

It is good that you had got referral to PCR test for HIV. I do not think it is going to make you feel too good before or after the test. It will add up more anxiety and stress. It is apparent with your recent loss of sleep and tiredness. Here I want you to promise me that you should never think of HIV/AIDS after the test is negative, will you?

I will be there for your reply.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Chakravarthy Mazumdar 48 minutes later
Actually I don't expect to experience much mental suffering related to the London trip and waiting for the results. In my mind there is only a remote change of maybe 1-2% that the test will be postive. I expect a negative test. If so I will do my best to change my thinking about HIV. At least I have done everything I can when it comes to testing for HIV. So then I will XXXXXXX the future with a more open and relaxed mind.

It will be a little hard to accept that i don't have a diagnosis for a physical disease, since I am convinced it is something physically "wrong" with me. I think the HIV anxiety has destroyed my relationship with my doctors since they believe I suffer from hypocondria. That is a burden for me. I will also have to deal with @that.

Also, I was told by a woman working in a laboratory in Norway that even some HIV-2 positives came out negative on PCR-test for HIV-2. That information will probably create some trouble for me even if everything come back negative from London. I realise that I have to work with this issue further (counseling).

Before I can continue my life I have to take these PCR tests for sure. No other option for me.
Answered by Dr. Chakravarthy Mazumdar 19 hours later
I can really feel putting myself in your shoes. I acknowledge that. But after all I have to be a treating soul and my goal is your quality of life.

You may have a physical disease but the mind is taking over the body. That is where the problem as I opine. Start practicing relaxation both body and mind, that is extremely important for you. This is irrespective of the lab result that you gonna have. This is very vague term if you do it for yourself and I prefer you guided by an expert.

I believe and pray that you come out clean.

All the best.

Above answer was peer-reviewed by : Dr. Aparna Kohli
Follow up: Dr. Chakravarthy Mazumdar 2 days later
Thanks for your suggestions. I will try relaxation exercices. I tried that last year, but because of my physical condition it made me even more uncomfortabel when I tried relaxing.

Right now I am experiencing a sore/burning/dry mouth. I just hope it is not fungal infection or gingivitis or strep throat. I have been bleeding slightly from my gums. Also I have my diarrhea back as I also had a couple of weeks ago. I guess most doctors would tell me it is due to stress related to my London trip, but I don't believe that. I also have even more problems with variations in my body temperature at night (very hot/sweating and then very cold when morning comes). I am hoping my health stays good for a couple of more days so I don't have to cancel my trip to London.

I will update you again when I come back or when I get the results and we can take it from there.

Answered by Dr. Chakravarthy Mazumdar 4 hours later

Do not worry, get the tests done. Let us continue after your report.
Above answer was peer-reviewed by : Dr. Aparna Kohli

The User accepted the expert's answer

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