Elevated liver enzymes and low white blood cell count

Question

First, let me say that some of your responses I have read have left me in tears. If ever want to try a second career stand up comedy could be a good fit.

My situation I have had 4 patners in the last 3 months all hetro vaginal sex and one hetro anal for only a minute(no lube). I was with one women 4 times unprotected the last time being July 15th. I have since been diagnosed with HSV-2 since our last encounter. About two weeks after last exposure I developed enlarged lympth nodes in my groin and flu-like symptoms; sore throat for a month with a slight dry cough, fatigue, muscle ache and generalized swelling of lympth nodes, hot flashes, headaches, but I have not had a fever or I just did not have one when I went to the doctor. Recently, I have also developed a bitter taste in my mouth. I have had a ELISA at 5 weeks and it was negative. I know that this is encouraging, but not definitive until 12weeks. My blood test came back and my white blood cell count was slighty under normal 4200 and my liver enzymes were eleavated. I did drink heavy three days before the test, so I do not know if that would affect it. I also was HEP c neg after 5 weeks. I just got a PCR DNA and another ELISA test on my 45th day and I will get my results next week?

Is HEP C negative after 5 weeks definitive?

Would a negative PCR DNA and ELISA test be definitive at 45 days?

I asked these questions because my internist and urologist do not seem to be be well verse in these areas.

Answer

Hi,

Your internist is not well versed in HIV and hepatitis C? Hmmm . . . then why is he still your internist?

Unprotected sex does place you at risk for STDs, including HIV. Consequently, screening is warranted. I agree: a negative HIV-antibody test at five weeks is indeed encouraging but not definitive. I do not recommend PCR screening for routine HIV screening, due to the rate of false positives, other technical concerns, cost, etc. Your elevated liver function studies deserve follow-up for all types of hepatitis as well as other ailments that can affect liver function.

My advice is simple:

  1. Repeat your HIV-antibody test at the three-month mark.

  2. Get an STD screen.

  3. Follow up with a qualified internist if your liver function tests are elevated.

Good luck!

Dr. Bob