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Dr. Lisa I, good question on WBC variation - nobody to ask!
Apr 3, 2012

Hello Dr. many thanks in advance for taking the time to help me I think from previous answers you might be the expert I need. I live in a country where I am a foreign worker and a HIV +ve status will result in my deportation. Medical expertise here is notoriously low (although facilities are good), so I dont have many options for "second opinion". I only have opportunities to check my sexual health whenever I have chance to leave the country (limited) Early Dec 2011: had HIV test Biolytic INSTI test and p-24 antigen test both negative also negative for syphilis, gonnorhea, chlamidya, Hep A, Hep B o After risky vaginal sex with few unknown-status females, last risk 4 months before test - zero risky encounters since

Early Jan 2012: began to experience neuropathic symptoms mostly in hands and feet but also in upper arms, legs sporadic relatively minor tingling, numbness etc which didnt have a definitive pattern but did seem to be related to posture (computer use) / fatigue / heavy gym sessions (I am an overweight ex-boxer who still tries to keep the spirit alive..) Mid-Jan 2012: did full check up(no STD screening) My results came back all normal (except overweight) and Dr. determined from questions / control / sensitivity tests that my neuropathy wasnt indicative of something serious gave me vitamin B12 supplements and a medicine called Lyrica to try for 10 days. I did not experience recurrence thru end-Feb Early March 2012: hand (mostly) and feet symptoms recurred, incl. pain, went back to another Dr. (my company insurance moved to diff. clinic) 20-25 March: several check-ups and testsCBC, blood sugar etc all came back normal except o Low vitamin B12 o Deficient vitamin D o Dr. thinks those are the cause and gave me supplements My question: In reviewing the results of the CBC from late March vs. the one from mid-Jan, I noticed by WBC had declined from 7.4 000(0?) per microlitre to 5.6 I pointed this out to the Dr. and he said it was normal and in line with the other movements within the CBC between the 2 tests (increase in various things associated with the red blood cells and other stuff I didnt catch), and that WBC varies depending on state of your body, time of day etc (I was just recovered from minor cold last time) - I didnt of course enquire about HIV do you think it could be indicative of HIV? I have not been worried about HIV since my test in Dec, and zero risky sex since but I am suddenly very anxious. Also I have had 3 colds this winter season from Nov to Feb - 1 heavy (just a cold though, for 2 days, no fever or aches), 1 light and 1 medium from Nov-Feb but I hadnt had any for 3 years before that. Appreciate your insight if I should get further testing for HIV the next time I have a chance. Many thanks in advance

Response from Dr. Hightow-Weidman

Hello there- From the symptoms, lab results and risk history you presented, I do not think that what you describe is indicative of HIV infection. While I can't quite explain your recurrent neuropathy, I feel confident HIV is not the cause. It also seems like the doctors are doing a very good job and evaluating you and prescribing appropriate tests and therapies. I wish you the best of luck. Take care,

LHW



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