"Clinical marker of hiv"...should i be concerned?

[XHK1980]

I've recently been diagnosed with "Proximal subungual onychomycosis" which is apparently a "clinical marker of hiv infection"..from what i've read and from what my doctor has told me it essentially does not occur in HIV negative people. I had a negative oraquick in home test 3 and 4 months post exposure... (a) Would such a specific symptom give me reason to doubt my 4 month oraquick..also (b) would an opportunistic infection such as this occur in relatively early hiv, or would this be something one would see in advanced disease. I had an HIV blood test last about a year ago..I am also on methotrexate, would this affect my oraquick results or delay antibody production?

[Edward W Hook, MD]

Increase rtes of fungal infections tend to occur in person with longstanding, not recently acquired HIV.  If you had HIV advanced enough to increase your risk for fungal infections, you antibody test would be positive.  Believe your test results- you do not have HIV. EWH

[XHK1980]

Thank you doctor, If i may ask...would an infection such as this occur early in the disease or later...basically...if I had enough copies of hiv in me to cause an opportunistic infection, would it/should it definitely show up on an antibody test?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  It is important for me to point out that virtually all "clinical markers of HIV infection" also occur in persons without HIV but occur more commonly in persons with advanced HIV.  This is virtually certainly the case for your fungal infection of your finger nails.  HIV tests such as the one you took play a critical role in determining whether persons with problems such as yours are related to an immunosuppressive problem such as HIV or just bad luck.  In your case,  your negative HIV test proves that HIV is not your problem. Believe the test result.

As far as the origin of your fungal nail infection, this could be bad luck or, possibly related to the methotrexate you have been taking.

I hope this comment is helpful.  Your test shows that you did not get HIV from the exposure you describe.  EWH

[XHK1980]

Forgive my followup before you've had a chance to answer..but..If this was an opportunistic infection due to hiv infection (early or late) should i have tested positive on my oraquick?