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Dropping WBC before meds

Apr 13, 2003

Always lived a healthy life, never sick, no drugs, married for 15 years, never took special precautions for sex, no extra-marital sex, wife HIV-, found out I was HIV+ 2 months ago after searching for reasons of prolonged anemia (hemoglobin below 12.5 over last year, 8 blood tests) and fluctuating WBC from 4000 to 1500 back to 3200, 2600 now 2000, also over a year. Had endoscopy and colonoscopy , all ok

First detailed blood test 3 months ago, before HIV test with CD4 120 (20) CD8 258 (43) CD3 384 (64) CD19 102 (17) CD56+ 78 (13) Hemoglobin 12.4 RBC 4.12 WBC 2300

After testing HIV+, doctor put me on Septrim 3 times a week for PCP because of CD4 120 and ordered new blood test (45 days after detailed one). Results VL 67K and CD4 109 (30 not a typo). I have been now on Combivir and Sustiva for 3 weeks. Feel good, no side effects. Other notables: Negative on all hepatitis and syphilis. I have a history of what I now think is genital Herpes with very mild symptoms a couple times a year. Not tested yet. Wife never had symptoms. Doctor does not seem to be worried about my low WBC. Should I be looking for something else than just HIV to explain CD4 109 (30) and overall WBC 2000 and its history, as my CD4 are dropping but there seems to be something else that is dropping more. Does this warrant a bone marrow biopsy? Many thanks

Response from Dr. Holodniy

I don't think it warrants a bone marrow biopsy yet. I would wait to see what your WBC does after a few months of HIV treatment. In addition, the septra and AZT in combivir can also affect (reduce) your blood counts. So your counts should be watched because of potential toxicity just related to the meds.

What do my results mean?
Low cd4, good cd4 count and undetectablect high3

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