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Low platelet/WBC count=HIV??

Aug 4, 2011

My boyfriend went to the doctor, at a walk-in clinic (PrimaCare), the other day to see if he was having a bad reaction to Bactrim anti-biotic. He had had an abscess under his arm and the doctor prescribed the Bactrim to clear up the infection. The doctor gave him a clean bill of health (no fever, blood pressure normal, urine sample normal, etc) and said he was probably just having a mild reaction to the abscess infection clearing up combined with the side effects of the Bactrim, and asked him to come back for a follow-up in 3 days just to be safe. He is now feeling fine, so declined the follow-up visit (because they were asking him to pay $100 additional). His doctor said his platelet count was 98 and white blood cell count was 3.3 and that he should come in for more testing and pay the money because he "probably has HIV", based solely on those two blood counts. He is planning to see an actual general practitioner anyway to get a complete physical in the near future, but based on those numbers alone is HIV a legitimate assumption to make?? I thought it seemed like a pretty dramatic statement but I am not a doctor. After doing some online research, it looks to me like the reduced counts could easily be from fighting off the infection he had in combination with the Bactrim (one of the side effects is reduced platelet and white blood cell counts), but should we be more worried? We mentioned these facts to the doctor and he said "you can't believe what you read online". We both were to the gyno within the past 3 months, are monogamous, and are not drug users just to give you an idea of our risk factors. I am just a bit freaked out by the whole situation. Please keep in mind we are both going back to our doctors anyway in the near future to clear away any doubt, but in the meantime I could use some feedback. Thanks!!

Response from Dr. Frascino


"Based on those numbers alone is HIV a legitimate assumption to make?" No, it's not. And the physician who advised that a platelet count of 98,000 and white blood cell count of 3.3 indicates your boyfriend "probably has HIV" is definitely out of line. There are many potential causes for low platelets and WBCs. Jumping to HIV as the probably cause is inappropriate. I suggest you follow through with your plan to avoid the pricey doctor with the bad bedside manner and instead see your general practitioner for your complete physical. Appropriate tests, including a screening HIV-antibody test, can be ordered at that time, if indicated.

Good luck.

Dr. Bob

negative test after 8 years
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