Hi docs,

Possible high risk exposure in East Africa 2 years ago. May have injected (shared needle) but can't remember as drunk (literally no memory but a feeling I had). I have never injected before or since.

Tests:

3 months - GUM - HIV and HEP C antibody negative
4 months - Freedom health - HIV DUO negative, HEP C PCR and antibody negative
6 months - GUM - HIV and HEP C antibody negative
11 months - NHS GP - HIV and HEP C antibody negative
21 months - NHS GP - HIV and HEP C antibody negative

Concerns:

Very ill 13 weeks after incident (vomiting, weight loss, diarrhoea)
Rash on chest for 4 months (doctor says something to do with hair follicles?)
Thin white lines on sides of tongue (doctor said not oral hairy leukoplakia and was normal, but it wasn't particularly prominent at the time).
Fairly frequent oral ulcers since August.

My GP says that I am not HIV and that basically I am a worried well. I would like your opinion as a doctor who specialises in this field, do you think I need to continue investigating HIV as an option or am I negative as my GP says. The problem for me in particular is the rash and white on side of my tongue, which have appeared about 20 months since exposure, which sounds about right. I have read about rare subtypes but don't know if this applies to me (E Africa). Also if you think it warrants more tests what should I use?

Thanks for all your help.

[Dr Sean]

Hello,

This sounds a story I remember..did I see you?

I 'm happy from what you say that you do not have HIV or Hep C.

There are other illnesses aside from these. You have, as is common, focussed on only a few.

The travel, the query injection drug use is of interest.

I think that in actual fact all will be well but I really can't do this justice in this Forum I'm afraid.

The "rare subtypes" issue is a non-starter. You don't have HIV - if you look through the Forum you will see that the rare subtype issue is a common one and one we de-bunk repeatedly and I'm not going through it again.

What to do? Well, we can see you again, but it will cost you a sizeable sum - without seeing you I can't tell you how much but maybe £900.

Thats a lot of money I think you'd be best off keeping because aside from the fact that your GP is very likely right the other unfortunate fact is that this is unlikely to be due to anything that happened and we are unlikely to find a cause.

My advice would be to:-

1) keep your money
2) ask your GP to do a full blood count, basic biochemistry, toxoplasmosis, hepatitis B test

If all negative then probably fine.

best regards, Sean

Hi Doc,

Good memory I did see you almost 2 years ago about this.

I think Hep B has been tested previously and came back negative so I think we can rule that one out, plus I was vaccinated for this. Apart from the strange rash which just looks like spots, and the thin line on my tongue, which my GP says is normal, I am feeling generally well.

Glad to hear you agree with the other doctors I have seen and that you don't think I have HIV, which is understandably my main concern. The money required to see you is an issue for me and I will return to my GP to discuss my other concerns. If there are still problems I may pay you a visit. Very frustrated that 2 years on and I'm still worrying about this, although I have now learnt my lesson.

Thanks for your advice doc.