Worried about HIV

[obsessiveGeorge]

Hello,

I would like to know how likely it might be that I have HIV.  I will need to give you a history so please bare with me.   Starting in June 2007 until the beginning of Oct 2008, I was very promiscuous and had sex with about 10 women.  Only 1 women was without a condom but she works at a clinic and tells me she tests herself very frequently (we had  a short relationship).  The rest of the women were pretty much one night stands (I feel pretty ****** about myself now).  Condoms sometimes can slide down the shaft of my penis slightly and that worries me. In Mar 2008 (after most of my sexual encounters), I got blood work done and tested negative for everything.  However, I had a slightly low WBC and a trace of blood in my urine which my doctor forgot to mention to me until much later (I had no symptoms).   In July, a skin doctor told me I had genital warts (I had them removed right away).  At the beginning of October I had sex for the last time.  At the end of Jan 2009 (around 3-4 months after having sex the last time) I got tested again for std's and was negative for all- but still had a slightly low WBC and a trace of blood in my urine.  I am getting an abdominal ultrasound soon and I think a kidney x-ray. I am worried that something like HPV (genital warts) can supress HIV antibodies and make my test negative even though I might be positive for HIV(Please keep in mind that I live in Canada where the HIV testing may be different then in USA i.e. I don't know if they do Elisa)?  What do you think of my situation and what is the likeliness that I might have HIV?  what could the low WBC count and microhematuria be caused by (I am mostly concerned of HIV)?  

Thank you for your time.  I hope I was thorough enough for you to clearly understand me.

ObsessiveGeorge

[Edward W Hook, MD]

You have little to worry about.  As you point out the majority of your exposures were condom protected making them safe, even if the condom slipped down.  In addition you have had negative HIV tests.  The testing systems used in Canada are essentially the same as those used her in the U.S. and are superb.  That you caught genital warts, given your history is not particularly surprising or alarming.  the presence of genital wart infection will not have a negative impact on your HIV test, it is just as reliable in persons with warts as in people who do not have them.

Your other two problems , microhematuria and a WBC which is on the low side are not in the least suggestive of HIV.  Each is a non-specific finding which could be entirely normal (this is the most common case) or are related to a huge number of other problems.  The lowish WBC needs no investigation or therapy and radiological studies of your kidney are an appropriate first step in evaluation of microhematuria.

My sense is that after a "wild phase" in your sex life you have decided that is not who you are and perhaps are feeling a little guilt/anxiety.  Please don't worry about HIV.  There is absolutely no reason to think you might have it. EWH

[obsessiveGeorge]

Thank you very much for your response...but just something you wrote posed a questin for me...

You mentioned that microhematuria and low WBC is not the least suggestive of HIV, then why is it that the internet sitings I have found suggest otherwise?  For instance, it states that HIV causes a low WBC count and 25% of HIV+ patients have hematuria.  And you are correct that I do not wish to be promiscuous anymore!!

[Edward W Hook, MD]

This is just the reason that searching the internet for "clues" to HIV risk is so very misleading and troublesome.  These findings are terribly misleading and non-specific and do little more than increase unnecessary concerns for persons trying to assess their risk.  Let me give you an example that is just about as misleading as the two you have focused on.  did you know that 100% of persons with HIV have been shown to have oxygen in their blood?  It's true but does that mean you have HIV if you have oxygen in your blood?  Of course not  since so do 100% of humans without HIV.  The way that data are presented, particularly without context can be misleading.  This is the reason we urge clients not to search the internet for "clues" when they can get answers through antibody testing.  This is also the reason that we decline to participate in debates as to why we say what we do about individual questions.  We simply do not have the time to correct all of the misperceptions that can be had through internet searches.  EWH

[obsessiveGeorge]

I am very sorry about that.
  I think you can understand the anxiety in people that would cause them to look in every corner for information.  Just one last thing, I said that my WBC was slightly low...it is actually 3.7, was I correct to say slightly low or is that considered low and a concern due to its quantified number.  

Thank you once again so very much for your answers...this service you and your colleagues provide is absolutly a great public service!

[obsessiveGeorge]

Oh... sorry I am leaving out one more thing.  Isn't it true that HIV+ patients are approximately 25% likely to have hematuria.  So why would hematuria and low WBC both show up in my system at the same time- thats a little weird to me?

I truely apologize if this turned out to be somewhat of a debate...I am just so stressed out and my mind forms all kinds of hypotheses!

[Edward W Hook, MD]

I won't debate you.  I quit.  You asked for my opinion, I gave it.   and 3.7 is just a little low.  there are millons of health peole with WBCs of less than 4.

You need to get over your HIV fear as there is NO reason to be concerned about it.  EWH