[Guest]

One month ago I developed urethritis and severe inflammation in my right knee & ankle, as well as my left wrist. First intense swelling in the knee, a few days later the foot, then gradually increasing pain in the left hand over about a week. There is no history of any form of arthritis in my family. My foot has a few reddish marks on the tops of the toes and there seems to be a soft pocket of something behind the right knee. (This is most easily observed with the leg fully extended.)
I intermittantly have had a mild fever (<=100 F) and do not have any swollen lymph nodes, AFAIK. I was very fatigued and run down a month ago, but that seems to be steadily improving. I have not had anything resembling a cold or flu since March 2001.
The urethritis is extremely mild and I didn't notice the miniscule discharge until a doctor examined me and told me to look for it. Some conjunctivitis developed in my right eye but it was no big deal and went away. In spite of treatment with doxycycline (100 mg/12hr) and Amoksiklav (1000 mg/12hr) for 10 days, the mild urethritis persists and urinalysis still reveals bacteria in my urine. I was travelling before the arthritis set in and was having what I thought was traveller's diarrhea; this promptly disappeared upon taking doxycycline. The joint pain seems to be slowly going away; mild activity seems to improve it but too much makes the foot swell and get very warm.


The reason I am posting this to an HIV forum is that I had unprotected sex in early december. The woman was a Peace Corps volunteer from West Africa and coincidentally(?)had a lot of pain in her knee which she said was due to some kind of problem that runs in her family. She last tested HIV negative one year ago. I was last tested in July 2000 and this is my first and last risky behaviour since then. I ended the relationship with her in December because it appeared to me that she was not being entirely honest. There seems to be a lot of information on the internet saying that reactive arthritis in young men is sometimes a presenting symptom of early HIV infection. Something to do with increased numbers of T8 or lowered resistance to the bacterial infections that seem to cause RA, at least in people with HLA-B27. (The most reliable and clear information seems to be saying that RA is rare but most frequently follows chlamydia or dysentery in people with HLA-B27.)
I first went to see a doctor while travelling in Slovenia (northernmost province of former-Yugoslavia). They did CBC and a few other tests (ESR was 90 and C-reactive protein was 196.1).
There are no units and the abbreviations don't mean anything to me, but here is what the results were:
L 16.2
RBC 4.99
Hb 153
Ht 0.45
MCV 90
They did not go into specifics, but said that the results were "not so good" and asked me, almost hopefully, if I had the flu. This all sounded rather ominous so I headed back to the US immediately. I am now fearfully awaiting the results of CBC and tests for HIV Type I & II. My primary care physician does not even know what HIV II is and I have no idea who to turn to if the test is positive. (I brought up the possiblility of HIV. It did not occur to him to even check.)

I am sorry for writing a short novel but I am very afriad and have no one to talk to about this until thursday when I will go see my doctor for the results.
Thanks for listening.

[Guest]

You sound like you had a classic case of Reiter's syndrome. It is often started by a gut infection or a std (chlamydia or a similar bug). Both of these you could have gotten in your travels. I know of no relationship between hiv and Reiter's. I've done a little research and can't find one either. However, getting an STD, any STD, does put you at risk for hiv. Still nothing you've said sounds specifically like hiv infection. GR
[quote] One month ago I developed urethritis and severe inflammation in my right knee & ankle, as well as my left wrist. First intense swelling in the knee, a few days later the foot, then gradually increasing pain in the left hand over about a week... [/quote]

[Guest]

It is controversial, at least according to the source I have quoted below, whether HIV can actually cause Reiter's. Thanks for the rapid response. I only wish my doctor and his lab were so fast....

http://hivinsite.ucsf.edu/InSite.jsp?page=kb-04-01-15#S5X
[quote] You sound like you had a classic case of Reiter's syndrome. It is often started by a gut infection or a std (chlamydia or a similar bug)... [/quote]

[Guest]

Just to let you know, my HIV test was negative but it appears I have some major liver problems--possibly Hepatitis C. (I have already been immunized for Hep A & B.) Now I'm getting tested for that.
Thanks for your comments.
[quote] It is controversial, at least according to the source I have quoted below, whether HIV can actually cause Reiter's. Thanks for the rapid response... [/quote]

[Guest]

Let me know what happens. GR
[quote] Just to let you know, my HIV test was negative but it appears I have some major liver problems--possibly Hepatitis C. (I have already been immunized for Hep A & B... [/quote]

[Guest]

The hep tests were all negative as well. My doc has no idea, but I think the elevated liver enzymes in my blood were due to my taking diclofenac. (Some studies I found on the web indicate that 10-15% of patients on diclofenac have elevated AST/ALT.) I stopped taking it immediately finding out about potential liver problems.

Well, the pain in my knee, foot and hand were back with a vengeance so I did some more ressearch and discovered glucosamine/chondroitin supplements. I was skeptical not just because supplements often suffer from chemical impurities (to put it kindly) but also because, if they're so great, why are doctors still prescribing NSAIDs?

After a week of taking 750mg of Glucosamine Sulfate and 600 mg of Chondroitin Sulfate every 12 hours, I am seeing some real improvement, at least in my arthritis.

I am, however, still going to see a rheumatologist this week to try to get to the bottom of all of this. Also, I will get another test for liver problems to be sure that diclofenac was really the cause.
[quote] Let me know what happens. GR
[quote] Just to let you know, my HIV test was negative but it appears I have some major liver problems--possibly Hepatitis C... [/quote]

[Guest]

I just read on thebody.com a posting by someone who claims to have read on HIVinsite.com that in persons with Reiter's Syndome and HIV, an Elisa test may be negative for up to two years after the initial exposure. The doctor's response was that he had never heard of any data supporting that claim. I had a negative HIV test 72 days after having unsafe sex with someone. My symptoms of Reiter's Syndrome have pretty much gone away. (Urethritis, Conjunctivits, and Arthritis) AFAIK, I have not had any skin lesions, or swollen or painful glands. I do not know the HIV status of the woman I stupidly slept with and we are not in contact.

What is the basis of this claim? I have searched hivinsite.com and can't find anything about reiter's syndrome having anything to do with the elisa test.
[quote] The hep tests were all negative as well. My doc has no idea, but I think the elevated liver enzymes in my blood were due to my taking diclofenac... [/quote]

[Guest]

I can't find any reference to this on either the ucsf hivinsite website or the hopkins website. I have no knowledge of this from my own reading and experience. Can you show me where you read it?
Thanks GR
[quote] I just read on thebody. com a posting by someone who claims to have read on HIVinsite... [/quote]

[Guest]

There were two questions and answers mentioning it, but now I can only find the one which doesn't mention HIVinsite:

http://www.thebody.com/Forums/AIDS/SideEffects/Archive/Muscle/Q12631.html

I wish these sites were like yours! It's impossible to find anything on TheBody.com or HIVinsite.

I am still concerned because, as my urinary/arthritic symptoms continue to abate, other symptoms are now appearing. I feel feverish from time to time, esp. at night and I have developed one sore, swollen lymph node in my neck for no apparent reason this week. Also, my appetite is not so great in the mornings. I feel kind of sick, but it usually passes by late-morning or noon. I have gained about 15-20 lb since January, but I attribute this to severe knee pain cutting my activity to nill.

My LFT values all are back to normal. CBC was normal on march 14th. ESR was normal as of March 14 and my joints look and feel normal. I have HLA-B27. Around march 20th, I was treated for gonorrhea with rocephin and biaxin, just to be on the safe side. I am going to consult my rheumatologist next week about my symptoms. I plan to have another HIV test in the first week of June, which will be 6 months after the last possible exposure. Is it reasonable to close this issue and get on with life if that test is negative? i.e. would you? That question which mentions Reiter's syndrome preventing ELISA from detecting HIV for YEARS scares the hell out of me.
I don't think I can take two years of this uncertainty. The next month and a half will be bad enough. What are the chances my first negative test result was false?

Thank you, GR. Your site has made this ordeal so much easier for me to cope with. I feel safer knowing there are people like you working on HIV.
[quote] I can't find any reference to this on either the ucsf hivinsite website or the hopkins website. I have no knowledge of this from my own reading and experience... [/quote]

[Guest]

Thank you very much for the compliment! It matters.
Reiter's syndrome makes people feel pretty ill. So everyting you've described may well be from that. If you're negative at 6 months I'd move on. The only other test to do then is a viral load. If that's negative, that's it. I'd only recommend doing it if you can find credible evidence that HLAB27 and Reiter's are associated with VERY prolonged false negatives.
I've read over the post at thebody that you pointed out. I know the Dr. who answered the post, Keith Henry. He is smart, well read, honest and reliable. He says that Reiter's does NOT alter your body's production of antibodies against HIV and therefore the diagnosis wouild be no different in a person with Reiter's. Sounds pretty clear to me!!
Unless you can find reliable information to the contrary, get an elisa and move on if it's negative.
take care, GR
[quote] There were two questions and answers mentioning it, but now I can only find the one which doesn't mention HIVinsite:

http://www. thebody... [/quote]