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Multiple symptoms suggestive of HIV

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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.
HIV test all time for CMIA and Elisa were negative.
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- should I stop testing for HIV ?
10- 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: Internal Medicine Specialist

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Category: Internal Medicine Specialist
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Thank you for using DoctorSpring Forum.

I shall list down my answers to your specific queries. For any clarifications please use the followups. Thank you

1. NO
2. No. - Those reports are from 1998-2004 when there were no sensitive tests. Now the late means late by few weeks. Not years for sure !
3. These are the conditions which can delay HIV seropositivity (although very very rare)
Immune dysfunction due to defective humoral response or agammaglobulinemia
Immunosuppression due to malignancy or medications
Delay in seroconversion following early initiation of antiretroviral therapy
Fulminant HIV infection
All of these disorders will be very evident in clinical presentation. You appear to have NO signs suggestive of these.

4. I need more information from you. Please see end of the question.

5. Very accurate. Since you had repeated tests the accuracy should be near 99%

6.Your Lymph Node has "non significant enlargment", It has nothing to do with this.

7. Your leukopenia is mild. I would say it is normal. Plus it DOESNOT mean that your body is not able to put a fight !

8. No . No such thing exists.

9. I am glad you asked this. If I were you at this point I would realise that I am being paranoid about possible HIV infection. Or even better I would have stopped with 3 HIV tests. There is NOTHING suggestive of HIV infection. So realx.

Regarding question no. 4 - I would like to know whether you had any significant medical illness in the past (including childhood). Any fungal infection of tongue ? (white coating ) ? Any diarrhoea ? any fever ?

You can reply as a followup.
Thank you

Patient replied :

Dear doctor thank you very much ...
For question four: no I don't remember that I was hospitliazed for a day in the hospital one case when I was two years old when I got Epilepsy due to hi fever that's all. I have currently Bactria or funges infection on my face as I stated in my question.
One more question
Do you believe with the current issues the 15 months and 9 tests are not enough to deduct HIV, is their any chance ?

The fungal infection is not related to Immunosupressoin.
It is unlikely that you had /have low immunity.

Chance is a wrong word to use in the scenario I guess. Yes there is negligible but small chance. But the if you take a lottery there is chance to win too ! You need not worry. Tests are negative. Symptoms are NOT suggestive of HIV either.

Thank you

Patient replied :

Dear doctor thank you very much, for being kind to me, just to clarify things:
1-Do you believe on window period and sero negative as I have consulted my doctor several time and he said it does not exist and it's myth?
2- I have swallen lymp and I am planing to do remove it for testing as it could be cancer do you believe this May be delayed the virus antibody?
3- I have seen your answer not confirmitve 100% I understand that medical field is not 100%, today I will complete 16 months and I want to get married and I can't due to my HIV concern, please help me..

1. Window period exists for sure. But it has become shorter and shorter now a days with new tests. Now it could be just few weeks.
Persistent seronegativity has been reported but it has been never seen in our institution. This is extremely rare (and may be myth!)

2. Single lymph node - non significant. I think you should leave it alone. If persisting you can consider a FNAC (needle biopsy)

3. Yes you should get married. DO NOT worry about HIV. You are clean form the records you have mentioned. Stop worrying

Hope this helps
Let me know if you need any clarification
Thank you

Patient replied :

Dear doctor bimlesh,
First of all thank you very much for your support and encouraging words heaps I would like to proceed in life, I got fit up from internet conflicting information every day I keep reading for almost 4 hours on HIV I was really scared and I don't know what to do and which to believe in addition we are almost 0 in medical education, just to rap up every thing:
I don't have HIV and my low WBC and lukopinea ( it vary )is not an issue for anti body generation or even delayed window period?
You are right it's only one lymp node very very small and always when doctor ask to see it they took time to identify the location, this is not an issue for window period or anti body generation? Finally as long as I can walk and talk and I am not hospitalized for serious health issue I should not be worried about HIV antibody , is the above correct?

Really appreciate you patience with me and with others with same anioxity and fear ... And I promise you no more follow up questions...


Yes, the low WBC is not a concern (intact it is low normal rather than low). The small lymph node can be just observed for now. And yes unless you develop any significant symptoms you do not need any further tests. I hope I have explained window period and persistent sero negativity. You definitely out of window period. And highly unlikey to be in a persistent sero negativity. (almost impossible)

All HIV related tests are negative and there are no specific signs or symptoms of HIV. So you can relax , get married and leave all these behind. Medical information in the internet has three main problems - 1) not written by experts 2)Not uptodate 3) no context.

Do not hesitate to ask followup questions. Infact I will keep this consult open so that you can get back to me at a later time, if needed.

Thank you

Dr. Bimlesh Dhar Pandey
Category: Internal Medicine Specialist
Senior Residency: Rhematology, All India Institute of Medical Schiences, New Delhi, 2009
Post Graduate, Junior Residency: MD (Internal Medicine), Rajendra Institute of Medical Sciences, Jharkhand, 2006
Residency: Physiology, Institute of Medical Science, Banaras Hindu University, Varanasi, 2003
Internship: Government Medical College, Trichur, 2001
Medical School: MBBS, Calicut University, 2001
Dr. Bimlesh Dhar Pandey and 4 other Medical Specialists are ready to help you

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