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Anal intercourse and HIV ELISA positive

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Dear Doctor,
I would like to get you decision on my case which was started on 12th may 2012, I had several protected and unprotected anal sex before this date, on that day was my last exposure. Since then I had several symptoms night sweating, headache, skin rash, fever, fatigue and swallen lymph node. I have done several tests on 3/4/5/8/9/10/12/14/15 months after that day, (CMIA and Elisa) tests. Results were as below:
WBC is always below normal (4-10) mine were between 2.5 to 3.6 change from time to time.
Vitamin D is always low normal is above 30 mine between 10-15
Anti-HBs ( positive) all time
Anti-HAV ( none reactive) at the first test on 3 months I got injection twice at 10 months test it was ( reactive ) since then it's reactive.
PB semear: negative for all tests done sometimes it's written ( luekopina) some time ( mild luekopina ) and sometimes it's writing normal.
Palates count are always within 190 range close to the lower range (150-450)
Usually the lymphocyte is higher than the range (15-45) mine usually from 46-52
Segment is lower than the range ( 45-75) mine is usually from 44-39 (one or two time within the range, same for lymphocyte )
Monocyte is high range (3-9) mine usually between ( 8-11)
I have now swallen lymph node close to my ear at the nick very small, still persist and not solid or painful just causing discomfort and headache at area around it. Now almost a year with almost same shape it's very very small.
I have also funges and Bactrial infection on my face bear area goes when I shave and once hair grows it's started again, we tried seveal medication and I visited several dermatologist with no solution before may 2012 I did not have it.
After I gave you my medical history in details I seek you help to answer the below:
1- do I have HIV?
2- in the internet there are reported cases 25 case I think for late window period, do you think mine considered late based on all above issues?
3- I have seen also some web posts shows that chemo therapy, organ transplant and immune system disorder can cause delay of HIV antibody, is my case considered immune system disorder?
4- weak immune system can cause delays, is mine considered weak?
5- how accurate CMIA test and is it for Ag and Ab ?
6- lymph node swallen can be due to HIV is it possible that my body did not deduct because of the swallen lymph?
7- last time tested doctor said lukopinea and before that either mild or normal does it mean my body currently either got damaged by HIV. Or unable to fight the virus that's why no antibody ?
8- is it possible that my body can work like carrier to the virus?
9- I hope you are never In my place but if you are what would you do?

Please help me to clarify all my concerns ...

Category: HIV- AIDS Specialist

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Category: HIV- AIDS Specialist
 24 Doctors Online

Hello,

Thank you for your consult at DoctorSpring.com. I understand your concerns and will try to help you best.

1. You are tested reactive for anti HIV antibodies that means preliminary positive results. You need to get a confirmatory test called Western blot for confirmation on HIV.

2. Yes, your case can be considered as late window period, because usually maximum by 6 months antibodies are produced to HIV infection, but in your case the test was reactive at 10 months.

3. Yes, it can be considered as a delayed response of the immune system, but not a disorder with the immune system. Every person's immune system reacts differently to same infectious organism, but that does not confirm or specify that it is a disorder of the immune system.

4. It is not considered weak, but the response of your system to this particular infection.

5. CMIA test is accurate and reliable. It detects p24 antigen and is the earliest detector of infection, even before antibodies are produced. But retesting at 12 weeks is recommended, which should again be confirmed with a western blot test.

6. Yes, lymph glands can be swollen, especially in viral infections.

7. Leukopenia, is a result of HIV infection hence you are noticing those changes in subsequent testing. Leukopenia can happen due to viral infections, HIV,diseases of the bone marrow, drugs destroying bone marrow, auto immune disorders and tumors.

8. Carrier state is when you do not have any symptoms, but in your case you have swollen lymph glands, flu like symptoms which are the starting symptoms of HIV infection, presentation might vary in every patient.

9. My recommendation would be to consult a Physician for treatment of HIV with antiviral drugs and monitoring the response to the treatment. There are multiple treatment options available these days and many advances in treatment are brought about to manage this situation.

I hope I have addressed all your queries in detail. Please feel free to discuss further.

Thank you.


Patient replied :

Dear doctor sorry I think you miss understood my question all tests of HIV was negative. And the 10 months issue was for anti HAV the doctor said you need to get injection for hepa A to get it reactive. So sorry appreciate if you can answer me again on the above basis ...


Admin Message :

Dear User , our peer review team has not approved the MDs consult reply. Hence your consult will be reassigned to another MD of same Speciality. Sincere apologies for the trouble.

Thank you


Patient replied :

What should I do wait only or rewrite my question?


Consult reply by Dr.Vivek Verma.

Hello,
Thank you for choosing Doctor Spring.
1. No, you do not have HIV, as you are tested negative even after the maximum window period.
2. No it cannot be considered that you might be having a long window period due to your immune system, because your system is responding well for other infections.
3. It is not an immune system disorder in your situation, as your system developed immune response to HAV immediately after getting vaccinated, that shows your immune system is working well.
4. Yes weak immune systems cannot produce a response, but they also cause other complications like frequent infections, even minor infections can become life threatening if immune system is compromised.
5. CMIA is accurate and reliable. It is used to detect p24 antigen and IgM, IgG antibodies for both HIV 1 and 2. But a negative test does not completely rule out HIV, as there is a chance that the antigen/antibody levels are much lower for detection through this test.
6. Yes swollen lymphglands can be due to any infection, especially if it is a viral infection. It can happen due to HIV, but can also be due to other viral infections like hepatitis, mononucleosis etc. Chances of it being due to HIV are less in your case, as you have tested negative.
7. Mild leukopenia can happen due to various reasons apart from HIV like common viral infections/ diseases of the bone marrow/ chemotherapy drugs/ auto immune disorders/ tumors.
8. There is no carrier stage as such, also if there are no symptoms that is very rare, you should test positive if you have infection.
9. You are very worried. I would suggest to relax as with testing and clinically you are not showing the symptoms clearly suggestive of HIV.
I would recommend that you consult a dermatologist as second opinion for examination and treatment of skin infections over the face.

Dear doctor Vivek,

Thank you very much, yes I am soooo worried as I am planing to get married soon and I want to proceed in my life normally without panic, I am tired from reading about delayed window period and sero negative cases I am seriously tired and I don't know what to do, low WBC and luekopina with swallen lymph node keep me crazy ... I had symptoms like rash, fever but symptoms never an indication that's why and internet posts actually drive me more and more crazy... I need the truth and I know for fact that medical field never give 100% result but facts always overrule,,, most of the answers shows that it could be HIV but there are other factors.

1- do you believe on the existence of window period and sero negative, my doctor said it's not true at all it's myth? But the internet as full of such stories??
2- my tests were both Elisa and CMIA depend on the lab I went to, do you believe that after a year there are still change either Ab or ag, can not be deducted?
3- do you mean for weak immune system people they are most properly severely sick or hospitalized?
4- last question doctor can I get married and I will not put my partner at risk?

At the end doctor I am very sorry if I am overreacting or my question look impolite and I am very sorry if you feel I am annoying person, wish you all the best and happy new year in advance ... Promise you no more follow up questions after your reply... Thanks


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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