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Negative tests - chronic symptoms

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  • Negative tests - chronic symptoms

    Dr., I appreciate your consideration and quick reply.

    First - I'm in the states. I've seen general internists, an Infectious Disease Specialist, and consulted many others. I also have a therapist lined up.

    I had an event I was told was no risk in November of 2017. It involved mutual m a s t u r b a t i on, and kissing. No s e x inter course. Just f i n g e r i n g and her giving me manual stimulation. My fear is that I shaved my pubic region that morning (about 10 hours previously) and had cut the area a decent amount and it bled while I was in shower. I cleaned with soap but I did not cover up any of the cuts with bandaids. While they bled a decent amount I'm sure they stopped bleeding relatively soon after. I don't recall looking at it later on but 10 hours passed and I went about my day and didn't notice anything unusual.

    I felt some palpable lymph nodes in my neck afterwards. Doctors examined them and did not think they were abnormal.

    I had a lot of tests. I had 4th generation tests at 19, 36, 95, and 370 days after the incident. I also continue even to this day (18 months later) take negative oraquick tests. I also paid for a QUEST Quantitative PCR RNA for HIV 1 at 26 days post exposure. All tests were negative.

    I settled down after the last 4th generation test that was over a year after the exposure. I also received oral in June of 2018, but I'm pretty confident that she had no I assume my 4th generation that december (6 months after the fact) would cover that too.

    I also had a full panel for ghon/chlym after both exposures and everything negative.

    What has me very worried now is that I seem to have Sebhorric Dermatitis, which looks to be an early sign of HIV. I never thought I dealt with this until this January, which would mean about 14 months after my dangerous exposure. This sent me into a new panic. However, after speaking with my wife (coming clean) she told me I had dandruff in my eyebrows forever, not just recently. Also - I found a picture from January of 2018, 6 weeks after my initial exposure, where I clearly had sebhorric dermatitis on my cheeks.

    My quesiton is, would 6 weeks be too early for sebhorric dermatitis to show up with HIV infection? Could it be part of ARS? I want to move on and believe my test results, but having a documented strong symptom linked to HIV has me worried all over again.

    I hope you can give me peace of mind. I know there was a lot, so I'll give you both exposures below and tests in relation to exposure

    Exposure 1 (mutual mast. with cuts from that morning in pubic region) - 19 days 4th generation, 26 days RNA PCR, 36 days 4th generation, 95 days 4th generation, 370 days 4th generation, and many oraquicks, through 18 months all neg. Also had full std panel at 95 days
    Exposure 2 (mutual mast and receipt of oral) 6 months 4th generation and oral oraquick at 1 year negative. also had ghon/chlym test 6 months after

    Thank you!

  • #2
    Dear worrieddad0206,

    Having read your detailed timeline of events, I would suggest you put this incident behind you and move on. From the tests you have done, you sound like you are in the clear.

    There is an association with HIV and seborrheic dermatitis. However, the vast majority of people who have seborrheic dermatitis do not have HIV. Your seborrheic dermatitis can be due to a variety of reasons, ranging from hormonal change, to weather, to skin infections, to it being idiopathic even. Please do see your doctor to try and see if there is any cause for it. But it does not sound like it is from HIV.

    Thank you


    • #3
      I see your worries as completely unfounded
      Seborrheic Dermatitis is a very common condition affecting 3-5% of the world's population
      It can present at any age
      There is no reason for you to think this is due to HIV
      Furthermore, you have had more than enough tests to be 100% sure you are not infected with HIV
      I empathize with what you are going through and it is easy to jump at every symptom
      And if you ask Google, literally every illness can be linked to HIV
      But the fact is you live in the States with cutting edge medical tech and the best expertise in the world
      On the background of these medical resources you have had enough tests for even the most conservative guidelines to conclude that you do not have HIV
      So to continue to worry about HIV is irrational
      Whatever symptoms you have going forward cannot be due to HIV
      I have attached a link to a very good MedScape article on Seb Derm
      Seborrheic dermatitis is a papulosquamous disorder patterned on the sebum-rich areas of the scalp, face, and trunk (see the image below). In addition to sebum, this dermatitis is linked to Malassezia, immunologic abnormalities, and activation of complement.


      • #4
        Thank you Dr.s.

        I appreciate your calming words and advice. Can I just ask 2 follow up questions to sort of put all of my apprehensions at ease?

        1. Considering your knowledge, was my risk even a risk in the first place? I’m speaking specifically of the first one due to the shaving cuts in pubic region the morning of the event.

        2. I know my previous post rambled a bit. I noticed the dry scaly skin that looked like SD this winter and I still get little breakouts. However looking back at old pictures I see some tiny dry spots even before exposure but they aren’t that clear. BUT I DEFINITELY have SD symptoms in a photo I found that was 6 weeks after the exposure. What I’ve read about SD in HIV it’s one of the earlier presentations but that’s like a year or more out im assuming? So the question is is 6 weeks too early for SD to present anyway?

        Thank you.


        • #5
          and Lastly I noticed some dry spots on my palms. Admittedly here I never looked that closely so it could have always been there. This winter I had some weird itching on my left palm for a few days but no dry spots where it was itchy and it went away on it's own. Just for your knowledge. Thanks and I'll let you respond and hopefully be done.

          Also - I have therapy lined up with a top therapist in late July. It's awhile to wait but he was booked. I'm hopeful with all of the medical evidence in my favor he can help the mental aspect of it. I have 2 children, both toddlers, one gets loose stool a lot in diaper and the other gets dry I connect both to how I may have transferred hiv to them. I know it sounds crazy but it's a sad place to be in my head.

          3. I have had loose stool for the past few months. Not diarreah but loose stool. So that plus seb derm are 2 symptoms of symptomatic hiv and it gets me going. Thank you.
          Last edited by worrieddad0206; 06-21-2019, 10:07 PM.


          • #6
            Dear worrieddad0206,

            As mentioned previously in this thread, we do not think this is HIV.

            These spots, loose stools and seborrheic dermatitis seem to be causing you a lot of stress, but they sound rather non-specific. Speak to your doctors about your concerns. However, I do not think you need to worry.

            Thank you


            • #7
              Thanks Dr. I really don’t intend to be one of these people that posts all the time. But last night I saw some white spots on 2 toenails and after a lot of scraping they came off. It looks like white superficial fungal infection. On the other foot I have some white gunk in cutical area.

              I took another oraquick test, were well over a year now and it was negative. But still I have some palpable lymph nodes for 2 years, and recent sebhorric dermatitis and now fungal infection in my toe!? This are tell tale early manifestations of hiv no?


              • #8
                Dear worrieddad0206,

                The fungal infections we are concerned about in HIV are the fungal infections of internal organs, mouth and systemic fungal infections. Fungal infections of the toenails are exceedingly common and are not considered an AIDS-defining condition or usually attributed to HIV. So rest assured, it is not due to HIV.

                Thank you


                • #9
                  Thanks. This is just what freaked me out as I have most of those symptoms besides weight loss.



                  • #10
                    On Monday please respond to this.

                    My wife mentioned to me that my daughter has very dry skin behind her ears. It’s flaky like dandruff. That’s a telltale sign for sebhorric dermatitis. I know you said it’s common but she’s 4. Everything I read about it is infancy and then in adolescence. Toddlers don’t get it. But she has it??? Is there any way I could have given it to her? What if I had a bloody nose once and she got some on her thumb, she’s a big thumb sucker what if all of that happened and she ingested a small amount of fresh blood? Could she contract it that way???

                    please respond to this new fear. I made an appointment at my dr and I’m going to get tested again but please let me know if I should get her tested. I don’t want to put her through the trauma of blood drawing if I don’t have to but I want to make sure I’m doing everything right.

                    Thank you. Please.


                    • #11
                      Hi. I realize you stopped answering. But my 3 year old daughter got a yeast infection.

                      I went to an urgent care facility where they gave me a rapid finger prick test. It was the chembio Sure Check which looks like a second generation. This would be 13 months after my last exposure and 20 months after my scarier exposure.

                      My only fear is that the tech who administered it punctured the finger, then wiped it, and then drew the next blood. I'm concerned that the alcohol and/or chemical from the wipe could have been in the blood that was tested and therefore throw the test off. Is it possible for that to occur? Please let me know.


                      • #12
                        Dear worrieddad0206,

                        Your daughter might have other skin conditions e.g. eczema, which is common in her age group.

                        Your worries and fears are unfounded. Your tests have shown you are HIV -ve. Everything else is just your anxiety. Please move on.

                        Thank you


                        • #13
                          Thanks. My last question is about my rapid test.

                          It was a year and a half after my first exposure and 13 months after second. It was the chembio surecheck which I believe is second generation. It was negative.

                          The quesrion is that the tech punctured my finger, then wiped it with antiseptic, then took the next blood out. The dr said that some alcohol contamination wouldn’t affect the test...but I wanted a second opinion on that. I’m asking because my 4th generation that was done 6 months after second exposure and one year after first was negative but the sample sat over the weekend so I wanted confirmation. Please answer thank you.


                          • #14
                            I know I've blown past what would be a normal limit. But between my seb. dermatitis, a chronic sore throat I had for 2 months last summer, and my kids rashes, I want to make sure both tests i had had no room for error.

                            1. 6 months after last exposure (naked grinding with no insertion (her on top of the bottom of my shaft) and received unprotected oral): My lab based 4th generation test was drawn Friday afternoon at my doctors office. The test was not ran until Monday, though. Can a blood sample lose it's potency waiting that long, if say not refridgerated? (I'm in the US)

                            2. 13 months after last exposure: As mentioned above, I had a rapid what looks like 2nd generation test a few weeks ago. I did it thinking this would be it and if negative I could finally move on. However, the tech punctured my finger, then wiped the spot, then began to collect blood. Curious if this was with an antiseptic wipe if this would impact the test at all? I know you dr's conduct tons of rapid tests so figured you had experience on it.

                            Please reply. I will not post again once you reply. Thank you.