Low Lymphocytes and Hiv Negative after 15 months - Conclusive?

Dear, Dr Hansfield:

Trust this finds you in the best of health!

I write to you once again – this time with some clinical conditions as diagnosed by my physician. Please do not chase me away by suggesting these are anxiety driven questions.  Below are some facts to help you with understanding and why I correlate the present condition with an HIV infection.

23 Nov 2008 – Exposure

25 Feb 2009 – HIV1/2 (ELFA): Non Reactive (96 days from exposure)

3 Feb 2010 - HIV1/2 (ELFA): Non Reactive (15 months from exposure)

* Test Administered – ELFA (Enzyme linked immune fluroscence assay)

Aug 2010 – Inflammation of the throat; Laryngoscope done; Treatment given

Sep 2010 –  I am unwell since 4 weeks with a viral and cough. My physician got a CBC and a malaria smear done immediately. The lab reported a Total WBC of 7400 and the differential as below.

WBC Differential:

Neutrophil 78% (40-75)
Lymphocyte 19% (20-45)
Eosinophil 2% (1-6)
Monocyte 1% (1-10)

My question:

Despite two negative HIV tests out till 15 months do you think my present condition of a low lymphocyte count with low grade fever, cough and fatigue warrants another  HIV test? Is it conclusive proof that I am indeed HIV negative?

Appreciate your advice.

Regards,
Hivedoff

[Edward W Hook, MD]

This is your third question since July, all of which represent questions regarding your concerns related to the same exposure and its consequences.. We ask clients to ask only two questions in any 6 month period in order to allow others access to the limited numbers of "slots" for questions on the Forums. As a result, I will provide a single answer. There will be no follow-ups and I ask that you not ask further questions on the HIV Prevention or STD Forums until January 2011.  

For you to deny that anxiety is a part of your problem is simply hard to accept.  I will provide you with an answer to your question and then what will hopefully an explanation.

Believe your tests.  You have had not one but two HIV tests at times when the results are absolutely conclusive.  When symptoms and tests for HIV do not agree the tests are always correct.  That your lymphocyte count is slightly below the arbitrary proportion used to define "normal" is of no consequence and is certainly not at all suggestive of HIV.

Finally, I will point out that I worry that when clients keep asking questions of health care providers about non-specific questions such as yours, this can sometimes lead to their undergoing unnecessary procedures and tests, putting themselves at risk because of the tests themselves as well as using up resources that could be used for other purposes.  You do not need to worry further about HIV related to the exposure you mention.  If you have other problems you need to work through them with your doctor but there is no reason whatsoever to still be concerned about the possibility of HIV.  

I hope this comment is helpful. Take care. EWH

[hivedoff]

Thank you for your answers and advice .

I as an individual only seek advice and depend on experience of esteemed doctors like you both, only for a simple reason - reassurance. Without your reassurance our chain of thoughts can run away anywhere !!

An idle mind can become a devils workshop. I thought it prudent to ask your advice on this correlation before the "devil" starts working out one for me. I meant absolutely no disrepect to healthcare providers or the doctor community. Without people like yourself around it would be difficult for us to manage situations like this. Deep appreciation to you and Dr.HHH for all the answers.

It is just that I am at a heightened state of anxiety. This state is further aggravated and triggered by physiological conditions. Nothing else. In such conditions the only balm to soothe the mind is Dr.EWH and Dr.HHH!

Take care Doctor!

[Sabal]

Dear sir, i had a sexual encounter with a prostitute 8 months back and my condom broke..i have frequent sexual relation with my girlfriend, unprotected. Nowadays im feeling lethargic, have mouth ulcers and rashes all over my body..my gf had a blood test for some reasons and the t cell and lymphocyte counts are pretty normal. Do i still have to worry about hiv? Would appreciate your reply at your earliest convinience.