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HIV and/or now Hep C or nothing? Nr 2
Sep 18, 2011

Dear Doctor, Thank you so much for your answer.

My CD4% was has been 38-44%, last 39%. I guess quite normal.

I am seeing infection decease specialist but wants your opinion if I can kill the HIV ghosts once for all, or if you in my case recommend testing until 12 months.. (I am not well)

Could HIV cause severe symptoms and still be undetectable? (below 50 copies..)

How likely is it that I will be HIV positive later? (no risk contact since.. not even a sexual contact..)

(I have never done drugs and I drink modestly)

Headache, and pressure behind the eyes (red eyes).. :(

Thank you so much!

HIV and/or now Hep C or nothing? Aug 28, 2011 Hi,

I have had severe symptoms in someting that I thought was HIV for the last 7 months.

It is a long story with lots of testing included.

Still tests HIV negative in antibody and PCR testing.

CD 4 in 300-400 range and now 400-500 range, severe tiredness, headache, sore throat etc etc..

Suddenly I test positive for Lyme, IgM..?? and then positive for Hep C, two bands and the following test only one band.. HCV PCR negative..

Enlarged spleen, AST 43, ALT 49 ...

Now waiting for second PCR for HCV..

Could it be a co infection? Late seroconverter of HIV?

Please help!

Response from Dr. McGovern

I am happy to hear that your HIV antibody and viral load testing are negative. However, your case sounds quite complex because of the enlarged spleen. If your CD4 percentage is normal but your absolute CD4 count is low, this could be related to an enlarged spleen. You will want to look at the results of both tests to see if this is the case.

We have shown that CD4 absolute counts can be low in a person with normal CD4 percentages if they have liver disease (McGovern Clinical Infectious Diseases). However your HCV PCR testing have been negative. Your HCV antibody testing is somewhat confusing but without virus in your blood you would not be at risk for liver disease no matter what. To be complete, you should have a blood test for hepatitis B as well.

I think you should see a specialist in infectious diseases because of your fatigue, headache sore throat and question of a Lyme IgM antibody test.....However, an enlarged spleen is not a major manifestation of Lyme, so further evaluation by an infectious disease expert is needed for more evaluation....

If there is no clear answer you may need to see another specialist to help explain your enlarged spleen.

I hope this is helpful.

Response from Dr. McGovern

So I see that your CD4 percentage is normal...I suspected this would be the case. I suspect that your lowish CD4 absolute count is related to the enlarged spleen. However, I don't think HIV infection is the answer.

I would pursue other diagnostic testing. If you have never had a HCV RNA test or HBV testing, you may want to consider that in light of these abnormal liver function tests. However, again, I suspect this will not be helpful in pursuing your diagnosis. THe key is understanding why you have enlargement of your spleen. If you are an adolescent or very young adult, EBV could be considered....



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