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What causes diarrhea after unprotected intercourse?

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Posted on Fri, 10 Nov 2017
Question: Dr.

I need some help. I need someone to read, digest my story and help me with some direction.

Exposure : 2-3 Unprotected Receptive Anal exposure(S) with possibl HIV positive partners while I have had 3rd grade hemmoroids, last one being at end of April 2016 (17 months ago). Until April 2016, My health was totally optimal without any issues.

Symptoms : ALL textbook symptoms. Please believe me as I will not list ALL those here. Since last few months symptoms are better. However, the following symptoms are not just part of my body.

1) Loose Stool in which more particles stays in bowl even after flush.
2) Muscle spasms along with pin and needle type pain. Muscle spasms are like every hour.
3) Severe tiniitus , 24/7 and can't get good sleep
4) No refreshing sleep. I used to wake up with 100% full energy next morning. Now, I just wake up with 0 energy and I need to force my self.

Test:
@ 73 week, I had had HIV EIA 4th gen test . It was negative
@ 73 weeks, I also had Pooled NAAT Test. It was negative

CD4, cd4% and CD4/CD8 ratios were following.

8 weeks, 1622 Absolute, 44%, 1.53
18 weeks, 851 Absolute, 41%, 1.36
24 weeks, 1056 Absolute, 39%, 1.45
36 weeks, 1200 Absolute
42 weeks, 1448 Absolute, 39%, 1.4
63 weeks, 1398 Absolute, 41%, 1.5

Questions:
1) If this is not HIV, Hep C or any other infection, Where to start ? Which doctor that I need to follow up with ?
2) I know that CD4 drops in acute phase and I believe my 18 week is the results of that. I can't believe drop from 1600 to 851. no reason or proper explaination from anyone.
3) I have had NAAT test @ 73 weeks. It was 24 pooled NAAT test and the detection limit was ~966 copies/ml.. I feel that if I had less then (since after acute phase, it drops at viral set point) that many copies, it would not have picked it up.
4) I have had numerous HIV DUO and Viral Load test at Metropolis Lab. My concern is if viral load may not have picked up some CRF or wild type strain then all of the test that i had was invalid. Does viral load test picks up all strain of HIV at all the Labs ?

I understand that Dr. provides reassurance in this type of case, I would like to get real help as I would like to move away with this.
doctor
Answered by Dr. Monika Dede (6 hours later)
Brief Answer:
Please don't worry. You are free of HIV.

Detailed Answer:
Hello,
Thank you writing in healthcare magic.

Based on your negative results of 4th generation test and NAAT test after 73 weeks after this risky exposure I think you shouldn't worry because you are free of HIV.
According the CD4 you should know that the normal CD4 range for an HIV negative person is between 460 and 1600, as you have . This is an average. Anywhere in this range is fine. So, even in some moments you have a CD4 851, this is consider a normal value and not a decrease value.
Absolutely, it is not necessary to do other HIV test and viral load because 4 th generation test, NAAT test and viral load are very accurate and conclusive in your case. Please don't worry because the viral load test detect all strain of HIV in all labs.
I think that these above mentioned symptoms are not related to HIV but with an other pathology. I suggest to meet a neurologist and psychiatrist to define better.

I hope my answer helps you.
Regards.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Monika Dede (54 minutes later)
Thanks for the answer.

1) In medical field, have you heard anyone taking more than 3 months to turn positive? I have heard longest seroconversion was at 49 month. I have also heard stories where ppl take years to test positive.

2) cd4 generally does not go down 800 points in 10 weeks.

4) are the 4th generation test same in all countries? Viral load test as well?
doctor
Answered by Dr. Monika Dede (29 hours later)
Brief Answer:
I never heard someone taking more than 3 months to turn positive

Detailed Answer:
Hello,
I am sorry for my late response.

In my experience in medical field I never heard someone than turn positive more than 3 months after exposure.
As I mentioned above the value of CD4 800 is a normal value and it is not consider a decrease value.Please dont'worry.

A 4th generation test and viral load test are the same and use the same tactical methode in all countries.

I hope my answer helps you.
Regards.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Monika Dede (3 days later)
Hi Dr.

Thanks for this information. I at know of following cases where it took long time for people to seroconvert or test positive and I'm not in medical field.

https://www.yyyy.yyyy.yyyy.yyyy/yyy/yyyyyys/PMC0000/
https://www.yyyyy.yyyy.yyyy.yyy/pmc/articles/PMC0000/
http://www.yyyyyy.org/ac0000/2009/11/23/yyyyyyyyy-hiv-infection

Currently, Ringing in the ears with so much loud sound, internal muscle spasms, fatigue, and lack of concentration are the main symptoms I've. Few days ago I had FLU with 102 fever and so much cough.

What is the absolute thing that I can do to (medically and scientifically proven) rule this out ? I was hoping that if i can get proper diagnosis for something else then i can rule this out...
doctor
Answered by Dr. Monika Dede (44 hours later)
Brief Answer:
Please don't worry!

Detailed Answer:
Hello,
I am sorry for my late response.

As I sad above I think you shouldn't worry because based on your negative results you are free of HIV.
So, it is not necessary to do other HIV test.


According your recent flu symptoms I think is just a viral situation not related to HIV.

I hope my answer helps you.
Regards.
Above answer was peer-reviewed by : Dr. Kampana
doctor
Answered by
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Dr. Monika Dede

Infectious Diseases Specialist

Practicing since :2003

Answered : 988 Questions

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What causes diarrhea after unprotected intercourse?

Brief Answer: Please don't worry. You are free of HIV. Detailed Answer: Hello, Thank you writing in healthcare magic. Based on your negative results of 4th generation test and NAAT test after 73 weeks after this risky exposure I think you shouldn't worry because you are free of HIV. According the CD4 you should know that the normal CD4 range for an HIV negative person is between 460 and 1600, as you have . This is an average. Anywhere in this range is fine. So, even in some moments you have a CD4 851, this is consider a normal value and not a decrease value. Absolutely, it is not necessary to do other HIV test and viral load because 4 th generation test, NAAT test and viral load are very accurate and conclusive in your case. Please don't worry because the viral load test detect all strain of HIV in all labs. I think that these above mentioned symptoms are not related to HIV but with an other pathology. I suggest to meet a neurologist and psychiatrist to define better. I hope my answer helps you. Regards.