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Nov 27, 2009

Hello Dr

I have a question about 12 weeks ago I got ghonnerea from a woman who's hiv status was unknown. Well 6 weeks after I developed viral exanthen small pink dots on abdoman and a painful white tongue the Dr said it wasn't bad but starting to grow to the front of my tongue and he couldn't find the cause. My blood work was norma except absolute monocytes were 998. Hiv and STDs negative. At 10 weeks symptoms persist so I see an hiv specialist she runs an rna and antibody test both negative. She says I have nothing to worry about. Gives me something for yeast doesn't respond. So 11 weeks I go back and she does a cd4 of 840 cbc everything within normal range monocytes back down to 598 but my absolute lymphocyte count 1670, it is always between 2300 2500 in past cbc. And I told her I was worried about a crf or a super infection that the pcr would miss or the antibody. So she said she would order a western blot. And if I was infected with something missed by the pcr she said bands would be present at this point in time. So my question is im a healthy 23 year old, well was isn't a cd4 of 840 quite low. And is that drop in my lymphocytes from 8 to 11 weeks concerning. And is it true that it would be rare for a western blot to have no bands present if I was infected at this point in time. Thanks a lot Doc. I appreciate your time answering these questions

Thank you

Response from Dr. McGowan

Thanks for your questions.

All things point to you NOT being infected with HIV. A negative HIV PCR would be stronger evidence that you are not infected than the Western Blot test. Most likely yuo had mononucleosis from either EBV or CMV. This can cause a transient drop in your lymphocyte count. Since CD4 is also a lymphocyte, your absolute CD4 count (but not the CD4%) would drop along with the other lymphocytes.

Would not worry any further about that past unsafe exposure. Use it going forward to be sure that you protect yourself.

Best, Joe

Newly diagnosed and viral load too low for genotyping
I read your response to getting HIV in 80's vs 20's

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