Please help me . Confused about CBC and HIV negative

[Jai1987]

Hello,

I had a protected vaginal sex with HIV positive woman and unprotected oral sex. I got tested at 4 weeks and 8 weeks after exposure. Both tests were lab corp ICMA tests and were negative. I had fever after 7 weeks and I went for cbc and it showed low platelets and high relative lymphocytes and monocytes but absolute values are in normal. Total WBC is in normal range . Platelets are 132 ( normal 150-400), percent lymphocytes 45 percent and percent monocytes 10.7, percent neutrophils 42 percent . RBC 5.6 and WBC 4.7 . So after fever, exactly at 8 weeks I was drawn blood for both HIV testing and cbc testing . HIV test came back negative but CBC showed above abnormalities . Everything I look about these abnormalities show up Acute HIV infection in many medical journals.  Also my platelets were 160 before the exposure. I m very very scared now . I don't know if I should take comfort in 8 week negative HIV antibody test or worry about turning positive at 12 weeks due to abnormal CBC . Please help me . I had sex only one time in life and now I m scared that I could be that very very unluckiest on this planet to test negative at 8 weeks and get positive after 12 weeks despite using condom. The only thing that worries about condom is I did not check if it expired or not and it's been with me for 6 months at home. The condom was covering my penis when pulled out and I hope there are no leaks in it . Actually I could see my semen when pulled out after ejaculating inside her. The test used at both 4 and 8 weeks is lab crop HIV 1/0/2 test and I guess it is third generation test.

Please doctor help me . Do you think with my CBC abnormalities , I would turn up positive at 12 weeks despite 8 weeks negative ? Also I tested at 8 weeks about 2 days after fever , so do you think antibodies would not have formed immediately after fever at 8 weeks ? I will be waiting on your advise.
Best,
Worried87

[Edward W Hook, MD]

Welcome to the Forum. I'll be pleased to comment, both by answering your question and by offering an additional even more important piece of advice.  That advice is to stay off of the internet.  There is so much incorrect and alarming information on it that it is, without a doubt, one of the worst things you can do in trying to sort out your situation.

You concerns about your exposure are not warranted.  your vaginal sex was condo protected and therefore safe.  When condoms fail thy do not "leak", they break wide open.  Similarly there are no known instances in which someone has gotten HIV from receipt of oral sex.

Having said that, I can also tell you that if your symptoms on week 7 had been due to HIV, your 8 week test would have been positive. Despite the overly conservative and out of date recommendations for HIV testing 12 weeks, the facts are that an 8 week test result is conclusive and your negative result proves that you did not acquire HIV from the exposure you have described.  Further testing will show the same result.

The CBC results you report are entirely non-specific and had they been due to HIV, your test would have been positive.  

I hope these comments are helpful. There is no reason to worry.  Take care. EWH

[Jai1987]

A related discussion, 8 weeks HIV is conclusive but re confirm after 3 months was started.

[Jai1987]

Thanks doctor. I will NOT ask anymore.

[Edward W Hook, MD]

Fianl answer.  The CBC results you report are normal and do not help diagnose HIV in any way.  As I said before- "The CBC results you report are entirely non-specific and had they been due to HIV, your test would have been positive."

The way HIV is diagnosed is with an HIV test, not a CBC.

I will not provide further answers. Further questions will be deleted without comment. EWH

[Jai1987]

Dear doctor,

I apologize, I am back here for a small question to you. I did my CBC differential with Quest diagnostics yesterday 3 months post risky exposure. Here are the results :

WBC : 7.8 (3.8-10.8)
RBC: 5.44 (4.2-5.8)
PLATELETS : 180 (140-400)
MCV 84.2 (80-100)
MCH 27.2 (27-33)
MCHC 32.3 (32-36)
RDW 12.4 (11-15%)
ABS NEUTROPHILS 3916 (1500-7800)
ABS LYMPHOCYTES 3268 (850-3900)
ABS MONOCYTES 429 (200-950)
ABS EOSINOPHILS 148 (15-500)
ABS BASOPHILS 39 (0-200)
NEUTROPHILS % 50.2
LYMPHOCYTES % 41.9
MONOCYTES % 5.5
EOSINOPHILS % 1.9
BASOPHILS % 0.5

I hope these are normal. Should i still need to follow up on CBC as my primary care physician suggested? Does this CBC look anything related to primary HIV infection. I know you said 8 weeks antibody test is conclusive and that I am HIV negative but anxiety about CBC results is killing me. I heard in this same forum that HIV test turns positive only after a week of ARS symptoms but i tested only 2 days after symptoms. Does it effect antibody detection even at 8 weeks?

Best,
worried87

[Edward W Hook, MD]

You are welcome.  EWH

[Jai1987]

Dear doctor ,

This support means a lot to me . Thanks for your time and advise .

Regards.

[Edward W Hook, MD]

Perhaps I was not clear above.  Worrying about symptoms is a waste of time. Your test results completely supercede concerns about exposure, non-specific lab tests, and symptoms.  If your symptoms were due to HIV, you 8 week HIV test test would be positive.  Your eight week test was negative, PROVING that you did not get HIV.  Concerns about condom expiration, symptoms and other non-specific labratory tests are meaningless.  Believe your negative 8 week test.  There is no need for further testing, at 12 weeks or an other time.  Further testing is a waste of time and money.  

I hope this is clear.  You did not get HIV from the exposure you described.EWH

[Jai1987]

Dear doctor ,

Could you please answer few more questions ?

1) I got fever and chills on day 53 and day 54 after exposure. I got tested for cbc and HIV antibodies on day 56. Is it too early to test for antibodies after fever symptoms ? Would an antibody test detect even after 2 days of symptoms ?
2) how often do cbc show abnormalities when fever and chills occur ? Is it pretty common ? Are my cbc values really alarming or slight abnormalities ? Will they go back to normal after few weeks ?
3) should I celebrate my 8 week negative antibody test as conclusive or should I get retested at 12 weeks too in case if the condom used was expired one bcz I m not sure of expiry date ?

I promise I will not ask anymore questions but please answer this one

Best regards ,
Worried87

[Jai1987]

Dear Doctor,

Thanks for the advise . I bought the condom at Kroger before 6 months and did not check its expiry date but the good thing as you mentioned it did not break apart and it's still has lubricant when used. So I m not sure if it expired or not. Also my fever started on day 53 and I got tested on day 56. Fever stayed only for 2 days and for about 4 hrs each day. Got easily treated with ibuprofen and aspirin. Do you think the test would have still picked up antibodies just 2 days after fever if it is infact HIV related ? I m thinking use of aspirin could have decreased platelets too. My platelets were only 160 even while I was Virgin. So , doctor should I breathe and take my 8 week third generation antibody test conclusive ? Or would you suggest me to still go ahead and test at 12 weeks ? Also can fever cause high lymphocytes and low neutrophils ?