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elevated WBC and worried about HIV

Doctor

I had some sexual contact with a sex worker of questionable HIV status. She used spit as lubrication for a handjob and there was probably blood in there that she smeared over my urethra.I got some of the typical ARS symptoms in the appropriate time frame like rash and headaches etc. I was told negligible risk by almost everyone except my doctor who said low risk. I did not insert my penis in her so that is why I think the risk is low. Is this considered mutual masturbation or oral sex?

My CBC test was returned with anelevated white blood cell count at 15.4/ The absolute neuts were at 9.7 and the lymphs at 4.5. The monocytes were at 1.1 and eos at -.1. Basophils at 0. The platelet count was 267 and red blood cell count was 5.79. It seems only the white blood cell count was flagged with neuts, lymphs and mono.

I am currently on a high dose of prednisone.

My questions are :

1) could these abnormal results be indicative of early HIV illenss even though I know the definitive test is the HIV test or can other things be at play? Does prednisone raise lymphocytes or lower it.
2) What happens during ARS? Does the white cell count go down and lymphocytes up ie does white cell count be below normal and the lymphocytes rise.
3) I know handjobs are no risk but what about saliva with blood? Is the risk virtually non-existent? Is there anyone that came to you claiming they got infected this way?


I would appreicate any understanding on this whilst I wait for my HIV test results. I am about 4.5 weeks post potential exposure.
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300980 tn?1194929400
MEDICAL PROFESSIONAL



Welcome to our Forum.  I will say categorically that there has never been a case of HIV  transmission which has been documented to result from receipt of masturbation. This is true no matter what was used for lubrication (including spit) and despite the fact that it is absolutely typical for persons engaged in masturbation activities to get each others' genital secretions on one another, including in the area of the penile urethra,  In your would case, in addition to the facts that I mention above, it is also worth pointing out that you do not know that your partner had HIV, a situation which makes it statistically unlikely that she had HIV at all.  The long and the short of things is that your symptoms were almost certainly coincidental and unrelated to the activity that you mention.  With this as background, let’s work through your questions:

1.  Your lymphocyte counts are in a normal range.  If anything, prednisone lowers, not raises lymphocytes while increasing PMNs.

2.  During the ARS lymphocytes counts can go down or up.  Trying to piece things together from a CBC is really a waste of time.

3.  See above.  Not only have neither of us ever seen a patient who acquired HIV in this way, there are no such reports in the medical literature.  

At this time you could seek testing with a combination HIV p24 antigen/antibody test and be completely sure that you did not get HIV.  Alternatively, at this time, an HIV antibody test would detect over 90% of recently acquired infections including all cases in which the ARS began more than a week ago.

I hope these comments are helpful to you. there is no need to worry.  EWH
Helpful - 1
300980 tn?1194929400
MEDICAL PROFESSIONAL
I suggested you test rather than waste your time with these non-specific measures which offer little relevant information.  I am confident that if you test, you will find that you do not have HIV.  There was no meaningful risk for HIV to start with.  EWH
Helpful - 0
Avatar universal
I am now worried because you are suggesting I test. Is this because of the non specific measures and I now have a risk or because you feel I had a risk. It is not clear to me. Given my facts,am I still expected to test negative?
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL
Please reaqd my original answer.  I repeat.  "During the ARS lymphocyte counts can go down or up.  Trying to piece things together from a CBC is really a waste of time."

I also indicated that  the elevation of neutrophilis is an expected side effect of taking prednisone.  

Your modest elevation of lymphocytes is not a concern.  Instead of playing games with non-specific measures, please just get tested.  To fixate on this is a waste of time and energy.  EWH
Helpful - 0
Avatar universal
The laboratory absolute reference ranges for Neuts is 2.0 - 7.5 and mine was 9.7

The  absolutelab reference range for Lymph is 1.0 -3.5 and mine was 4.5

The absolute lab reference range for mono is 0.2 - 1.0 and mine was 1.1


From what I understand from my research one has to look at the lab reference ranges to see if the readings are elevated. Do you still consider my lymphocyte to be in normal range give these ranges?  This is what really worried me is the potential lymphocytocis?.I have read online that high lymphocytes and high WBC could be a marker but I just don't know?

Thank you for your assistance/
Helpful - 0

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