Not a typical testing question

Thanks For answering DocH in your busy schedule.
I am back with another confusing question.  I tested positive for EBV as you can recall.
In week 9-10 my specialist ran a PCR which came back <50copies (negative)with a negative antibody test.  The next week (due to lab confusion of a P24) she had the test ran again with a CD4 and CD8 count.  My result came back from the CD4 at 208 and 133 respectively.  I am still awaiting the results from the P24.  I am needless to say worried sick about this.  Can these low counts be due to the fact that my diet has been non existant, stressed and a EBV?  Or could it be that the PCR was ran a week earlier and in that time frame the HIV destroyed my CD4's and CD8's?  That is my biggest fear.  I am have night sweats and slighlty swollen lymph nodes in my neck with a general feeling of weak muscles and tiredness.  My weight loss has stabled at about a 8-9lbs loss.  Do you have any insight on this?  Could my situation considered to be immune compromised and that is why I am not seroconverting?  Please help me with this.

Thanks

[H. Hunter Handsfield, M.D.]

I recognize your username but don't recall anything about your previous thread.  But you can relax.  The reliability of HIV tests is not affected by EBV infection, and your results show you don't have HIV.  Your symptoms are entirely consistent with your acute EBV infection (i.e., infectious mononucleosis), which also affects CD4 and CD8 counts.  I'm sure your own provider has told you all this, and that person probably knows as much about these things as I do.

I won't have any other comments on this thread.  I'm not going to delete the several comments made before I posted this result, but no more please.  Take any further discussion over to the HIV Support forum.

HHH, MD

[DrStupid]

HIV does not destroy CD8.
Your CD4/CD8 ratio is over 1.5 and that, if anything, is evidence against HIV.
Sounds to me like you're fine, trust your tests.

[MIK67]

thanks for the thought but my CD4's are around that of a person with AIDS....  I am not sure if the reactivation of the mono, with stress and my lack of any sort of diet (nerves) can do this???  How on earth can this be?

[DrStupid]

Wait to see what the Doc says ( I'm a Ph.D., not an M.D.)
I think there are conditions that depress lymph counts.
You might want to see an ID specialist in person.

But your multiple tests prove without a doubt that you don't have HIV.
The low lymph count doesn't change it.
By the way, CD8 counts are typically high in HIV-infected people, not low.

[MIK67]

Thanks for the advice....  I have a Phd but in engineering.... What I am worried about is the PCR was taken 1 WEEK BEFORE the CD4/CD8 count came back so low, thus leaving that time for less than 50 copies to reproduce and destroy my CD4 count.  The doctor I am seeing is an ID specialist.  She said it is possible the EBV reactivation/mono could do this.....but 208/133???  Shouldn't I be in a hospital?

[DrStupid]

Well, there you go!  You just got a bad case of EBV/mono, that's all.  Wait it out, it will pass on its own.

Forget your crazy theory about viral loads.  My Ph.D. is in HIV virology, not engineering, so you can believe me: forget about HIV.

No more comments from me here, sorry.

Get well.

[H. Hunter Handsfield, M.D.]

Having an abnormal test result isn't a reason for hospitalization.  What would they do for you in a hospital you can't do at home?

Your ID specialist doc is the person for any further questions.  That person's knowledge about acute HIV infection and EBV probably is better than mine anyway.

This thread is over.  Please note that forum rules permit someone to post a maximum of 2 new questions every 6 months.

HHH, MD