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Worried about WBC count

Dec 23, 2006

Dr. Frascino, thank you for taking a look at my question.

I am a gay male that is not very sexually active. I have only had anal sex once in my life (1990), and since then about the only sexual encounters I've had have been receiving oral sex and frottage/jo.

About 15 months ago, I was diagnosed with urethrytis after receiving oral sex from a massage therapist. Since that time, I have been driving myself nuts about the possibility of having acquired HIV either from that encounter or from other encounters of receiving oral.

I just had a physical, and my WBC came back as 4.6, and in the past it has run 5.1 to 6.0. Although 4.6 is in the normal range, it still seems low compared to what I've had in the past and it seems pretty close to being outside the "normal" range.

Prior to having my blood taken, I had been on the following medicines:

1) Medrol dosepak (completed 2 weeks before blood taken)

2) Levaquin (10 days for sinus infection, completed 5 days before blood taken).

3) various decongestants

My question is this: Would any of these medications cause my low WBC, and if not is this lab result something I should be concerned about?

My doctor doesn't seem concerned, but he has no idea that I am so worried about HIV and I'm embarrassed to say anything to him. I've also had a number of canker sores and developed minor acne over the past 4 months, which is contributing to my anxiety.

Thank you for your time.

Response from Dr. Frascino


The medications in the time frames you listed would not affect your ability to make anti-HIV antibodies, the duration of the window period or the results of your HIV-antibody test. Your doctor is not concerned (and neither am I, by the way) about your 4.6 WBC, because 4.6 is indeed normal. WBCs have a "normal range," because they go up and down within that normal range for a wide variety of reasons. Should you be concerned? No, of course not. What part of "normal" don't you understand? Your fears are entirely unwarranted. Your HIV risk is extremely low. If you are worried, get an HIV test three months or longer after your last potential exposure. Do not try to second guess WBCs or symptoms or anything else. The basic rule is "if you've placed yourself at risk for HIV, you need an HIV test!" Finally, you shouldn't be embarrassed to discuss any health-related issues with your doctor! After all, that's what you are paying him for! If you can't be honest and comfortable with your current physician, find one that better suits your needs!

Good luck. Stay safe. Stay well.

Happy Holidays.

Dr. Bob

Merry Christmas, Bobby Bob

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