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Dermographism and HIV (conversion)
Hello,
I am a 38 yo man from Belgium and belong to the high risk community of MSM. Two months ago I had one singel unsafe sexual contact with another man with unknown HIV status. I engaged in receptive anal sex for about 10 minutes without ejaculation. He was uncut and told me he should be ok because he normally plays safe except for few occasions he does not (but then he only is 'top', not 'bottom').
I have done 2 HIV tests, the first at 28 days (4 weeks) after exposure and the second at 46 days (6.5 weeks) (both of them were of the DUO type searching both for Ag P24 and Ab, the first one was from Biomérieux, the second was the 'Architect' one from Abbott). Both of them were negative. I have also been tested for other STD at 28 days, all negative. So, theoretically, based on all information I have been gathering and reading, including on the forum here, I should be fine, but I am not !
The reason is: about three weeks after my exposure I had a few days a soar throat (very mild though), and the week thereafter some loose stools (but apparently only after exposure to some specific foods like for example eating cold ice cream). I was not so worried about this since I did not have other symptoms like fever or swollen lymph nodes or a rash. But what also must have started by then, and which is still the case now, I have developed for some month now a general itchiness and red stripes on my back when scratched. I went to the dermatologist and I was diagnosed with 'dermographism' (urticaria = hives caused by physical contact on a very senstive skin). The dermatologist did not see something like the typical HIC rash (the maculopapular rash). I am on anti-histamine therapy for two weeks now to treat the itchiness and the hives. It works relatively well, but I can still feel there is something wrong with me (with my skin). It could be chronic. The origin is not known, it could be an allergy (I am allergic to grass pollen) or something else (a serious disease).
So I feel still worried, even more and more, thinking this sudden appearance of dermographism for more than a month now, could be a reaction of my body to HIV. But why would neither of the two HIV tests I have done pick up anything?
1. Because I am a later convertor? One of those <10% who convert after 6 weeks? Because I am more prone to it as an allergic type?
2. Because there is a second window period between the detectibility of P24 antigen and antibodies and I have been tested in that window?
3. Because the sensitivity for P24 antigen in those DUO tests is not high (about 80%?) and therefore the test could have missed out on me?
4. Becasue whatever I don't know...
Please tell me what are my odds here? My life has become a daily torment not understanding.
What also spooks into my mind is that dermographism and itchiness is caused by the release of histamine through own cells (calles mast cells) as a reaction to an allergen (could be an antigen?). Histamine release has a fucntion in the activation of the immune system (whether appropriate or not like for an allergy or an auto-immune disorder). By now taking anti-histamines would that not impair my immune response to a possible HIV infection, making things even worse?
I am planning to retest at 3 months again but in the meantime, I really help I could get some support and clarity from this forum.
I am a 38 yo man from Belgium and belong to the high risk community of MSM. Two months ago I had one singel unsafe sexual contact with another man with unknown HIV status. I engaged in receptive anal sex for about 10 minutes without ejaculation. He was uncut and told me he should be ok because he normally plays safe except for few occasions he does not (but then he only is 'top', not 'bottom').
I have done 2 HIV tests, the first at 28 days (4 weeks) after exposure and the second at 46 days (6.5 weeks) (both of them were of the DUO type searching both for Ag P24 and Ab, the first one was from Biomérieux, the second was the 'Architect' one from Abbott). Both of them were negative. I have also been tested for other STD at 28 days, all negative. So, theoretically, based on all information I have been gathering and reading, including on the forum here, I should be fine, but I am not !
The reason is: about three weeks after my exposure I had a few days a soar throat (very mild though), and the week thereafter some loose stools (but apparently only after exposure to some specific foods like for example eating cold ice cream). I was not so worried about this since I did not have other symptoms like fever or swollen lymph nodes or a rash. But what also must have started by then, and which is still the case now, I have developed for some month now a general itchiness and red stripes on my back when scratched. I went to the dermatologist and I was diagnosed with 'dermographism' (urticaria = hives caused by physical contact on a very senstive skin). The dermatologist did not see something like the typical HIC rash (the maculopapular rash). I am on anti-histamine therapy for two weeks now to treat the itchiness and the hives. It works relatively well, but I can still feel there is something wrong with me (with my skin). It could be chronic. The origin is not known, it could be an allergy (I am allergic to grass pollen) or something else (a serious disease).
So I feel still worried, even more and more, thinking this sudden appearance of dermographism for more than a month now, could be a reaction of my body to HIV. But why would neither of the two HIV tests I have done pick up anything?
1. Because I am a later convertor? One of those <10% who convert after 6 weeks? Because I am more prone to it as an allergic type?
2. Because there is a second window period between the detectibility of P24 antigen and antibodies and I have been tested in that window?
3. Because the sensitivity for P24 antigen in those DUO tests is not high (about 80%?) and therefore the test could have missed out on me?
4. Becasue whatever I don't know...
Please tell me what are my odds here? My life has become a daily torment not understanding.
What also spooks into my mind is that dermographism and itchiness is caused by the release of histamine through own cells (calles mast cells) as a reaction to an allergen (could be an antigen?). Histamine release has a fucntion in the activation of the immune system (whether appropriate or not like for an allergy or an auto-immune disorder). By now taking anti-histamines would that not impair my immune response to a possible HIV infection, making things even worse?
I am planning to retest at 3 months again but in the meantime, I really help I could get some support and clarity from this forum.
Teak,
Yes, I know that but I want to understand more than just that.
Why do you keep sticking to the 3 monhts window while so many other experts and labs claim the latest 4th generation combitests are statistically > 90% accurate at 1 month.
Do you not believe these statistics or is your response based on the remaining percentages that still need to be cleared?
Appreciate your response
Yes, I know that but I want to understand more than just that.
Why do you keep sticking to the 3 monhts window while so many other experts and labs claim the latest 4th generation combitests are statistically > 90% accurate at 1 month.
Do you not believe these statistics or is your response based on the remaining percentages that still need to be cleared?
Appreciate your response
There are no tests marketed or sold that will give a conclusive negative test earlier than 3 months.
I have a question before this exposure how many times have you been online researching HIV??? Along with the different test??
Hello Alienshadow,
I have been researching all this only the last weeks, after my exposure.
The reason I became really worried was the onset of the dermographism, and then the 'road to (dis)information hell' started...
I have been researching all this only the last weeks, after my exposure.
The reason I became really worried was the onset of the dermographism, and then the 'road to (dis)information hell' started...
Thats what I had guessed.. I want you to know this I have been there and I feel your pain.. But take it from me dont fuel the fire the more you look the more you will worry and then it just leads to more and more and it never ends... Bottom line by the time you do except you are negative you have done the damage to your mind and body... So relax and I know its hard the window period is a mother to live through.. I wish they had an instant test that worked within 24 hrs of the exposure but they dont... Find things to keep you busy and to keep your mind away from the worries goodluck...
Dear Alienshadow,
Thanks for your reply. It helps to know there are people like me out there. The uncertainty makes my life a daily torment. I barely understand how I get through each day. And then having to appear 'normal' towards 'people' at work, in the family, friends...
I am starting therapy to deal with my anxiety this evening.
But what about all the confusion on the window periods. Why is there so much conflicting information. Why do experts like the ones here (Dr. HHH, Dr Sean..) are so comfortable about the 28 days tests (one side of the road) and then there are the official guidelines in US (3 to 6 months) and the opinions from people like Teak. I guess nobody really knows it...
I have also posted my question to the expert forum, hoping to receive an answer soon from an experience doctor.
I hope you do feel well now and fully relieved.
Thanks for your reply. It helps to know there are people like me out there. The uncertainty makes my life a daily torment. I barely understand how I get through each day. And then having to appear 'normal' towards 'people' at work, in the family, friends...
I am starting therapy to deal with my anxiety this evening.
But what about all the confusion on the window periods. Why is there so much conflicting information. Why do experts like the ones here (Dr. HHH, Dr Sean..) are so comfortable about the 28 days tests (one side of the road) and then there are the official guidelines in US (3 to 6 months) and the opinions from people like Teak. I guess nobody really knows it...
I have also posted my question to the expert forum, hoping to receive an answer soon from an experience doctor.
I hope you do feel well now and fully relieved.
Oh i do feel well for 3 yrs now and you will to.. The confusion is the CDC they are very conservitive and they will always be that way... So your best bet is to test at 6 weeks and then follow up with that negative result.. If it helps any at all since I have been here which has been 4 yrs now I have never seen someone test positive after a 6 week negative result... I am sure you will get clarificaton on the expert side...
Thank you so much Alienshadow. I hope you are right about all that.
But like you know, because you have been there, when we are trapped in those anxiety loops in our minds, it is really hard to get back to normal. I would need a 'brain reprogramming or reset' to clear my inner cloud of fear.
But like you know, because you have been there, when we are trapped in those anxiety loops in our minds, it is really hard to get back to normal. I would need a 'brain reprogramming or reset' to clear my inner cloud of fear.
Like I said man just get your mind on more productive things and the time will fly by... Take that from a guy who knows the anxiety and fear along with the stress... I have to be honest I havent posted in awhile I am glad I have stepped back in.. Hopefully you are feeling a little better.. I just try to relate because I know its hard to cope...
Dear Alienshadow,
I got my 10 weeks test results today and they are conclusive. I am HIV-
And the HIV expert and clinic I went to confirmed that 6 weeks is 99% conclusive after 6 weeks. Thanks for your support. Full answer from Dr. Sean and my reply is also visible on the expert forum.
Dear Teak,
I really appreciate your straight forward answers, but please accept reality that you are living in the US where the combitests have only been this year approved while in Europe the experts have many years of experience with those tests. 6 weeks for combitests is also here in Belgium the golden standard. No need to worry about the 3 months window anymore, except for those 1% very unusual cases (either people with severe immune disorders or people on PEP, not one of the other people categories will turn positive after a negative combitest after 6 weeks, not one, as confirmed by the HIV experts at the university center I talked to today). Never have they seen a case of that in more than 5 years of experience using combitests, except that single only one on PEP who turned positive at 8 weeks, the so-called 1% case, should be more the 0,1% case based on thousands and thousands of people tested.
US is not always ahead in terms of scientific progress, and certainly not on medical care.
I got my 10 weeks test results today and they are conclusive. I am HIV-
And the HIV expert and clinic I went to confirmed that 6 weeks is 99% conclusive after 6 weeks. Thanks for your support. Full answer from Dr. Sean and my reply is also visible on the expert forum.
Dear Teak,
I really appreciate your straight forward answers, but please accept reality that you are living in the US where the combitests have only been this year approved while in Europe the experts have many years of experience with those tests. 6 weeks for combitests is also here in Belgium the golden standard. No need to worry about the 3 months window anymore, except for those 1% very unusual cases (either people with severe immune disorders or people on PEP, not one of the other people categories will turn positive after a negative combitest after 6 weeks, not one, as confirmed by the HIV experts at the university center I talked to today). Never have they seen a case of that in more than 5 years of experience using combitests, except that single only one on PEP who turned positive at 8 weeks, the so-called 1% case, should be more the 0,1% case based on thousands and thousands of people tested.
US is not always ahead in terms of scientific progress, and certainly not on medical care.
Thelastbullet, while searching for info on dermographism, I came across your post. I am so glad your test came back negative. I have had dermographism for about 13 years now (since I was 19). I got dermagraphism after a really stressful time in my life. I definitely think there is a connection there. When reading your post it struck me that yours developed too during a very stressful time. Also, at least for me ( though I went undiagnosed for four years), it took months for the antihistamines to kick in and control my symptoms to where I felt normal. Just food for thought. :)
"Why do you keep sticking to the 3 monhts window while so many other experts and labs claim the latest 4th generation combitests are statistically > 90% accurate at 1 month."
B/c >90% accurrate is not 100% accurrate. 3 mon is 100% accurrate (or at lesat 99.99...%). Read the Dr.'s forum and I think you'll see they've never seen a 4 week negative go positive later on, and that they even believe 6-8 weeks as conclusive.
B/c >90% accurrate is not 100% accurrate. 3 mon is 100% accurrate (or at lesat 99.99...%). Read the Dr.'s forum and I think you'll see they've never seen a 4 week negative go positive later on, and that they even believe 6-8 weeks as conclusive.
Dear Mia,
Thank you for your response. I am so glad to read that you make a connection between dermographism and stress. I am starting to believe (and wish to believe) my dermographism is linked to the acute stress I have been experiencing during the last months when I was worried about HIV. I have done a lot of damage to myself; All the fear, self blaming, guilt (the conviction I needed to get punished for unsafe sex), the acute panic attacks, and also hiding all this for the outside world, including my partner...must have put my central nervous system in OVERDRIVE. The CNS regulates the bodily systems, including the immune system. So it makes sense to me that my immune system has started to overreact to MYSELF. My skin disorder has literally put myself into quarantaine for sex, for going out, for life...
And it is not over yet. My mind is still not fully believing I am HIV- despite I had another HIV test at 13 weeks (the official window period passed) and it was again negative. Part of me is afraid I might be a late sero convertor, or that i might have been co-infected with hepatitis C (which could delay seroconversion) or that I have a pre-existing immune disorder that causing my body not to produce antibodies...but why would I be that special, extraordinary case....that would make me a medical wonder (or disaster)...Why can't I just let it go and relax and accept reality? Maybe my body and spirit need more time to recover from all the negativeness from the last months.
I am still researching the dermographism, another visit to the dermatologist planned, but I already know that my blood work has been checked twice and nothing seems to be wrong (liver, kidneys, allergies, thyroid, blood cells, hep C, all STD apart from HIV...all CLEAR). So I think my dermographism must have a psychosomatic link, although I find it hard to believe that stress can induce such a severe clinical reaction, but maybe my HIV fear episode has triggered a 'sleeping condition', maybe this was the last drop to get the bucket overflowing...maybe the last two years of STRESS i have been suffering from, mainly at work (very bad atmosphere and a new boss I can't stand) and some other issues have been building up and that also caused me to become kind of self destructive in seeking sex with other people, and playing unsafe.
The strange thing is that I have the idea that first my symptoms started and then only I started consciously worrying about HIV (linking it to an unsafe sex encounter), but maybe subconsciously I was already triggering the fear of HIV,....I don't know exactly.
When my dermographism was diagnosed more than 2 months ago, I had to take 4 anti-histamine pills a day to control the symptoms (it made me feel even worse). Now I am only taking one pill a day and it seems to be ok, meaning the itchiness and inflammation is controlled, and I don't get hive anymore but still depressed skin and edema tracks on my back and arms when scratched or rubbed. My fingers and foot sools get dry and feel numb often from the pressure (walking, typing),...and in my face i have acne (haven't had that since i was a teenager) eruptions. My skin seems to be producing a lot of oil, so I guess that is also a part of the dermographism, my blood vessels obviously open and contract all the time...oil getting trapped easily and creating the mostly under my skin pustules...I am also very sensitive to heat and cold. I can have sweat outbreaks on my back or forehead, I can feel outside freezing temperature as very painful to my hands...all of this i think is part of the dermographism. It is not only the itchiness and hives, it is much more than that. It is a de-regulation of the bodily system.
My doctor told me to visit an andrologist, a hormone specialist to look further than just the thyroid function. I will do this end of this month. Hormones can cause all these symptoms. And stress can severly impact hormone regulation in the body.
I hope eventually i will find the origin of the dermographism and heal from it or at least get it under control without having to take antihistamines for life.
How are you dealing with it now? You never had the dermographism gone after it started? You take pills everyday, how much, which ones. Have you found relief in other stuff (like alternative medicine or dietary supplements?)...Tell me, i am very interest to know your story and how you see it.
Thank you for your response. I am so glad to read that you make a connection between dermographism and stress. I am starting to believe (and wish to believe) my dermographism is linked to the acute stress I have been experiencing during the last months when I was worried about HIV. I have done a lot of damage to myself; All the fear, self blaming, guilt (the conviction I needed to get punished for unsafe sex), the acute panic attacks, and also hiding all this for the outside world, including my partner...must have put my central nervous system in OVERDRIVE. The CNS regulates the bodily systems, including the immune system. So it makes sense to me that my immune system has started to overreact to MYSELF. My skin disorder has literally put myself into quarantaine for sex, for going out, for life...
And it is not over yet. My mind is still not fully believing I am HIV- despite I had another HIV test at 13 weeks (the official window period passed) and it was again negative. Part of me is afraid I might be a late sero convertor, or that i might have been co-infected with hepatitis C (which could delay seroconversion) or that I have a pre-existing immune disorder that causing my body not to produce antibodies...but why would I be that special, extraordinary case....that would make me a medical wonder (or disaster)...Why can't I just let it go and relax and accept reality? Maybe my body and spirit need more time to recover from all the negativeness from the last months.
I am still researching the dermographism, another visit to the dermatologist planned, but I already know that my blood work has been checked twice and nothing seems to be wrong (liver, kidneys, allergies, thyroid, blood cells, hep C, all STD apart from HIV...all CLEAR). So I think my dermographism must have a psychosomatic link, although I find it hard to believe that stress can induce such a severe clinical reaction, but maybe my HIV fear episode has triggered a 'sleeping condition', maybe this was the last drop to get the bucket overflowing...maybe the last two years of STRESS i have been suffering from, mainly at work (very bad atmosphere and a new boss I can't stand) and some other issues have been building up and that also caused me to become kind of self destructive in seeking sex with other people, and playing unsafe.
The strange thing is that I have the idea that first my symptoms started and then only I started consciously worrying about HIV (linking it to an unsafe sex encounter), but maybe subconsciously I was already triggering the fear of HIV,....I don't know exactly.
When my dermographism was diagnosed more than 2 months ago, I had to take 4 anti-histamine pills a day to control the symptoms (it made me feel even worse). Now I am only taking one pill a day and it seems to be ok, meaning the itchiness and inflammation is controlled, and I don't get hive anymore but still depressed skin and edema tracks on my back and arms when scratched or rubbed. My fingers and foot sools get dry and feel numb often from the pressure (walking, typing),...and in my face i have acne (haven't had that since i was a teenager) eruptions. My skin seems to be producing a lot of oil, so I guess that is also a part of the dermographism, my blood vessels obviously open and contract all the time...oil getting trapped easily and creating the mostly under my skin pustules...I am also very sensitive to heat and cold. I can have sweat outbreaks on my back or forehead, I can feel outside freezing temperature as very painful to my hands...all of this i think is part of the dermographism. It is not only the itchiness and hives, it is much more than that. It is a de-regulation of the bodily system.
My doctor told me to visit an andrologist, a hormone specialist to look further than just the thyroid function. I will do this end of this month. Hormones can cause all these symptoms. And stress can severly impact hormone regulation in the body.
I hope eventually i will find the origin of the dermographism and heal from it or at least get it under control without having to take antihistamines for life.
How are you dealing with it now? You never had the dermographism gone after it started? You take pills everyday, how much, which ones. Have you found relief in other stuff (like alternative medicine or dietary supplements?)...Tell me, i am very interest to know your story and how you see it.
Whatever your symptoms are they are unrelated to HIV and you've conclusively tested negative. Take your other questions to the proper forum. This forum is HIV specific.
Thanks for telling me Teak. How odd, now it is you who reassures me that my 3 months test result is conclusive, while because of my health issues, I think the 6 months window is is the only real conclusive window. Why else would the CDC and other institutions still mention this 6 month window, it comes back everywhere as some kind of 'exceptional but possible' event. Why else would the testing procedure say that for health care people (occupational risk) and for sexual risk with a known HIV+ person, the rule is still to get tested after 3 months, and to follow up after 6 months. While this procedure to retest after 6 months is not considered for the other risk events (the 90% cases of low risk or heterosexual sex or sex with a person with an unknown status). As if the clinical outcome would be different for different classes of people. I really don't understand this distinction.
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