Dear Dr.

Please help me ! How likely or possible is it that one is HIV infected given anemia, leukopenia, thrombocytopenia, oral thrush, nausea, fever and fatigue, the last 4 persisting for 6 months (having started 4 weeks after possible exposure)but having negative ELISA+p24 at 4 months and negative ELISA(HIV1 and 2) at 6 months and 7 months? Could one still be in the pre seroconversion window or could symptoms be due to another HIV strain (HIV-O)? I would welcome your advice please regarding the need for further HIV testing! Thank you

Hello,

Negative HIV antibody tests out to 6 months are considered very conclusive that you do not have HIV. Anemia, leukopenia, and thrombocytopenia mean that something is suppressing your bone marrow's production of red blood cells, white blood cells, and platelets. Thrush can be a sign of a depressed or deficient immune system or a result of aggressive use of antibiotics. Nauseas, fever, and fatigue can be related to a vast array of medical conditions. What should you do? If your anemia, neutropenia, and thrombocytopenia are significant, then you should be seen by a hematologist (specialist in diseases of the blood). If he/she finds out that your immune system is depressed or deficient, then an immunologist might also be consulted. There are a number of conditions other than HIV that can cause all of the problems you list. See the hematologist as your next step.

Good luck.

Dr. Bob