Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date. I have a very unusual case. I would like to know if it is possible to be HIV negative via multiple antibody & viral load testing 15 months after a single risky exposure in Thailand, but still run the risk of developing HIV/AIDS from that exposure?
My symptoms that I developed more than 12 months ago have been unexplained following assorted testing by multiple doctors - all these symptoms have remained chronic: neuropathy (diagnosed polyradiculapthy via lumber puncture & EMG), chronic post nasal drip, dry mouth & sore throat, chronic diarreha (rapid weight loss of 15 lbs 12-13 mos ago), body shape changes (thinning legs & arms, fatter stomach), chronic fatigue (low testosterone measured) & vision change. Doctors also ran 4 different CD4 tests over last 12 months, ranging from 430-700, but now my ID doc says my problems can't be HIV related since I tested negative for antibodies after 6 months.
Prior to all of this, I was a perfectly healthy 45 year old white male. I've read that older white men are more prone to rapid wasting from HIV, and that sometimes autoimmune disorders can delay seroconversion by messing up the immune system response. Is there a way to test for HIV via semen or tissue samples? Isn't it possible that I could still have attracted HIV from this single episode 15 mos ago, but that the neuropathy/CNS damage has distorted my immune response? Do you think it's possible that the Thai woman I was exposed to could have been taking the failed experimental HIV vaccine, and that could have somehow mutated the HIV virus into something the tests here in the US can't pickup?
Please help me by replying to my questions. If there's a specific test I should take, please recommend it. Thank you.
For many reasons, I would strongly doubt that you have HIV disease in any form or AIDS.
None of the conditions or symptoms that you describe, however real, are particularly suggestive or specific of HIV Infection. While neuropathy may occur as part of HIV, or as a complication of therapy, this is not seen 15 months post infection. It takes years. Likewise, "wasting" with AIDS happens after years of infection, even in older patients. The thinning of arms and legs you describe in particular, while seen in patients with advanced disease, is generally described in those with a history of years of drug therapy. Fatigue and low testosterone are common in 45 year old men, as well.
Tests for HIV antibodies from blood are really very accurate. Of course, nothing in medicine is ever 100%, but 99.9% is pretty good, especially if you have had several tests, and a negative PCR as well. Auto-immune disease is not really a big problem for these tests, and you don't describe any history of such a condition. The blood is the best source of material for testing. There are no other tissue tests that would be of any use in your situation.
If the contact in question had an HIV vaccine in a clinical trial, the vaccine is not a possible source of infection. HIV vaccine candidates must have zero risk of making a productive HIV infection. Most are composed of dead viral proteins or of gene sequences inserted into unrelated, innocuous viruses.
In short, I am as sure as one can be from a note on the Internet that, based on the information that you relay, that you are very unlikely to have HIV disease. I do not know the origin of your neuropathy, and understand your frustrations. If you remain concerned, you might seek a second opinion from another doctor in your area. Perhaps another point of view could help you to discover the origins of your problems.
I wish you good luck
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