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Petechia, bruises and HIV

Apr 27, 2013

First I would like to thank you for the work you are doing here. I am asking your help because I feel my doctor isnt investigating enough due to lack of funding. I am 26 have HIV and Chronic Hep B, am on Combivir+Norvir+telzir for few years. My problem is I discovered petechia (confirmed by dermatologist) and bruises, and I dont remember where I got them. I seem to notice them pretty often. Petechia are not many and bruises are small and yellow but I am very worried something is wrong otherwise I would not notice them often. Dont take any other medicine except some multivitamin. In the last 6 months I have done 3 complete CBC counts, except my RBC that is low and MCV and MCH that are high (my doctor sais is macrocitosis due to combivir, I have it for years, it seems stable) everything else is normal. I also had some coagulation tests done (last one in April 2013) APTT, PT, PT%, INR, Coombs test, bleeding time, trombine time all within range.AST/TGO, ALT/TGP, ALKP, GGT also normal. NRBC also were tested they were 0. The abnormal tests are total protein 8.5g/l (upper limit was 8.2), creatinine 0.5mg/dL (lower limit was 0.8), high cholesterol and triglycerides. I sometimes have mild nightsweats. Abdominal ultrasound (December 2012) showed enlarged fat liver but normal spleen. Chest X-ray clear but internal lymph nodes or those that could be seen on the chest X ray were slightly inflamed and the doctor told me they could stay that way all my life because of my HIV infection. Neck, armpit, groin lymph nodes doc said they were fine. CD4 are as it follows November 2012 CD4-915, cd4% 30%, and April 2013 cd4 656 and cd4% 43% (lympocites were 1500). Is this something worrying? Viral load undetectable for more than 10 years . I am deathly afraid of leukemia , lymphoma or cirrhosis. Can they be ruled out? Thank you so much Im waiting nervously for your answer.

Response from Dr. Holodniy

You don't indicate what your other white blood cell counts were, and what your platelet count is. A normal bleeding time would indicate your platelets are working normally, although your symptoms could be associated with low platelets. If all your cell counts are normal, and the differential does not show any abnormal cells, then blood cell cancers are very much less likely.

Medication is necessary?
CD4/CD3 counts.

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