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Confusion over testing

Dec 9, 2005

My general practitioner initially came to me with concerns over my WBC which remained slightly low over the course of about 1 year. He referred me to a hematologist who discovered my neutrophil levels were low. We monitored my CBC over a period of 1 month, and the neutrophils ranged from ~700 to ~1100. He assured me at this point my blood counts did not suggest HIV infection.

He performed a bone marrow biopsy to clarify the low neutrophil levels and performed a blood test beforehand. The biopsy showed no abnormalities, but two days later my general practitioner called me and gave me the news I was HIV+. Strangely enough, my hematologist left the hospital within one month of my testing with no reason provided.

Ive since seen an HIV specialist who performed the typical blood tests. My viral load came back at 209,000 and my CD4 at 168. The only risk of exposure I was aware of occurred less than two years prior.

My questions then are what would cause a hematologist to think a patient was not infected with HIV when their WBC came back low and their CD4 numbers suggest AIDS? How common is it for CD4s to drop below 200 within two years for a very healthy, 21-year old male? And why would my general practitioner be the one to deliver the results to me (within two days no less) when he did not perform the test?

Response from Dr. Holodniy

I cannot speak for what the hematologist was thinking, or how it came to be that your general practitioner gave you the results. Although unusual in someone so young to have low WBC, HIV is only one of many possible diagnoses that could cause this. You don't indicate that the hematologist obtained a CD4 count and that the result was low. Although not common, we certainly see people within 2 years of infection that have this kind of CD4 count. Regardless, HIV treatment is clearly indicate for you.

Levels in HIV
CD4/CD8 relationship

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