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Can HIV cause LYMPHOCYTOPENIA and night sweats?

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I had protected oral and vaginal sex 3.5 months ago with a prostitute. I had a shaving cut above my penis and below my belly. Closer to the penis. I am worried about HIV transmission. 2 weeks after the episode I had head aches, lower abdominal and groin pain, lower back pain and nagging pain in my legs. The leg pain has persisted to this day. I've had 7 different HIV and std tests at various locations and times since the episode. The most recent was at weeks 12 & 13. All negative. My concern is the blood work done at week 13. The following concerns;
WBC 4.2
Lymphocytes 19.1
Absolute Lymphocytes 800

Everything I read says the 800 range puts it in a Lymphoctopenia stage and it mostly points to HIV. I continue to have bed sweats nightly, pain in the lower back, groin and legs. Should I be concerned about HIV or except the week 13 results? What else could could cause this 800 reading? Could my body have not produced antibodies by week 13?


Category: Sexually Transmitted Diseases(STD)Specialist

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Category: Sexually Transmitted Diseases(STD)Specialist
Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Hello.

Thank you for your query at DoctorSpring.com.

I understand your concern.

Let me assure you that you do NOT have HIV. With 7 different tests coming out negative, there is practically no possibility that you could be infected with HIV. Nowadays the tests used to detect HIV are 4th generation antigen-antibody combo tests which can detect the infection as early as 3 weeks post-exposure. Moreover, the HIV tests are nearly 100 % accurate. A negative test when done after the appropriate time period, which has been the case for you, means that you do not have HIV.

The additional points in your history which go against HIV is first of all, the really low risk you had with a protected act. The likelihood of HIV spreading through open cuts is very low.

The headaches and pains elsewhere are non-specific, and do not indicate HIV infection. They could have been due to a general viral infection which regularly affects all of us. Its more likely that they could be due to anxiety. Anxiety is capable of producing a variety of physical symptoms.

Your WBC, lymphocytes and absolute lymphocyte are all normal. They are on the lower limit of normal but still these values are normal. You do not have lymphocytopenia. The white blood cells which include the lymphocytes are a dynamic population of cells whose number increases and decreases as a response to challenges to our body's defense system. The variable levels you have demonstrate that you have a healthy immune system capable of responding to immune challenges. So you do not have to worry about it. For your reassurance you can repeat these tests after 2 weeks.

You body would have produced antibodies by week 13. You should engage in activities to de-stress yoursel like meditation, mild aerobic exercise etc. Also, you should try and do regular exercise like walking daily which improve your overall health and muscle endurance thereby reducing your aches.

I hope that answers your query. Let me know if I can assist you further.

Thank you.


Patient replied :

I'm feeling much better after reading your response. Thank you. My primary doctor did review the blood tests today and basically agreed that the lymphocyte numbers were within range, low end of the range. I am excepting the negative HIV result but can't help but think something with my body is off. Unless you are interested in the symptoms I will just tell you my body is off. I haven't had what I would think of as herpes leasions, but should I be concerned about herpes? I did have a type specific test at the 12 week mark that was negative. Next week will be 16 weeks, would you suggest I follow up with another herpes test? I'm really finding it hard to believe this is all caused by stress and anxiety, but if so, is there an over the counter medication that you could suggest to help settle my mind? I appreciate your service and look forward to your response.


Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

Hello.

I am glad that my response helped you. Please do describe what you mean when you say your body is "off".

You should not be concerned about Herpes because you have tested negative for it and you do not have any lesions. Repeating the Herpes test is not required because an infection with Herpes manifests within 12 days of exposure and in your case it has already been 13 weeks with no symptoms and negative tests.

I understand it is hard to believe that anxiety can result in physical symptoms but this is true because our bodies are regulated primarily by our brains which process both our physical as well as our emotional functions. So it is common to find physical symptoms in psychological conditions and vice versa.

Anxiety is known to result in fatigue and muscle tension. Headaches, pain in the neck, shoulders, and back are commonly reported by patients with anxiety.

The good thing is with appropriate management of anxiety, by anti-anxiety medications and cognitive behavioral therapy, you will obtain relief. Unfortunately anti-anxiety drugs are all prescription drugs. You can try meditation, exercise, a favorite sport/hobby etc to de-stress yourself. For the aches, you can take an OTC like Tylenol or Advil (Ibuprofen 400 mg, twice daily with food for a week).

If after a week, symptoms persist, you can consult a Psychiatrist.

Thank you.



Patient replied :

Thanks Again. I'll start with whats going on currently with my body. Most of the aches and pains have been below the waise with the exception of lower back pain and a couple days of kidney pain. The last few weeks have been pain in the groin area, including the lymph node area around the groin, one day of sharp pain in the ureathra that seemed to radiate to the feet, the nagging pain in my legs mainly behind the knees, the last few days have been tingling or burning in my feet and occationally my fingers.Yesturday started a crawling feeling in the lower abdomen just above my penis area. I seem to have something that resembles jock itch tho I have never had it. They most consistant thing for the last few weeks is the night sweats. A few hours after I fall asleep I wake with my hair drenched and legs quite wet. There has been pain quite often in the peineum area below my testicles and around the anus.
My upper torso has a breakout of pimples on my back and sholders, I was attempting to attach a picture but it doesn't seem to let me. They are red with a white center that do not pop. I woke one morning and while putting on deoderant I noticed the skin in my arm pits had peeled and had a red ring around it. The reddness is gone but the skin peeling is still noticable.
I will focus on my mental health and try to de-stress as you descibed, but I think the important thing for me is that I know I have covered all basis on the physicl side before I can let go. Is there any chance I should be concerned about a bacterial infection of any kind. Again, thank you for your help.


Matt


Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

Hello. Thanks for writing to us once again.
As i mentioned earlier, the chances of you getting any STD or even a bacterial infection is completely nullified and you also have conclusive evidence since all your reports are negative. It is absolutely natural for people to have anxious moments, however now i feel it is kind of bothering your personal life and daily activities. Night sweats as you have mentioned can be a symptom of anxiety because otherwise in your case there is no medical reason why you should be getting any night sweats. Since you are complaining of some lower back pain and abdominal pain, it is better you get an Ultrasound- Whole Abdomen done, just to rule out any other ailments.
I will once again like to repeat that you don't have any chances of picking up any bacterial infection. Breakout of pimples can be attributed to an allergy. It can be caused due to excessive heat or some irritant. I will adivse you to apply Histocalamine lotion on top of these pimples, around 2-3 times a day for the next one week.
Kindly focus on de-stressing yourself. If anxiety is really that troublesome, you can consult a psychiatrist who will give you anti-anxiety medication for a few days, and it can be helpful. I don't want your anxiety to troubl your personal life or your daily activities.
For the time being, if you can trust me, just relax. You haven't picked up any STD, or any other bacterial infection. If you still think there is an infected lymph node in your groin, it can indicate some other infection ( not because of STD ), but it is better to be examined by a general surgeon in that case who can palpate the lymph nodes and confirm if they are enlarged. In case they are, the doctor will start you on Tab. Doxycycline 100 mg twice daily for around 7-10 days and you will be fine.
Hope this helps,
Regards


Patient replied :

I thought I would post my latest and ask advice on my recent findings. I have excepted the fact that I did not contract an STD from this encounter. Because of some nagging issues my body has been presenting I decided to get a full bloodwork done. The most recent things that have been going on is almost constant pain in my legs, occational tingling in my feet and fingers, ocationally I have problems focusing my sight, what I would call jock itch tho I have never had it (red lines/rash between my testicle area and leg), skin peeled in my armpits and it to has occational rash, and I've noticed a very foul oder from my armpit. The oder is not a typical BO. So a couple things I noticed from the bloodwork was my Vitamin B12 level was 251, I'm not sure if this is concidered low or not. The one level that stood out was the Glucose level at 108. As I understand the range this puts me in the pre diabetic area. Reading up on pre diabetes I see a few of the sysmptoms that are similar. I will follow up with my doctor next week, but I would like your opinion on weather this glucose level could be part of my ailments?
Thank you very much again for your professional advice and input.


Expert:  Dr. Deepu Sebin Sebastian replied 1 Day.

Hello Matt.
It is good to hear that you are no longer anxious of having contracted an STD.
The constant pain in the legs could be due to muscle fatigue, especially if your job involves constant standing. Regular exercise can help by building muscle endurance. A Vitamin B12 level of 251 is considered a borderline result. Since you have occasional tingling in hands and feet, you can start yourself on Vitamin B12 supplementation.
The rash in groin folds and arm pits, and the foul smell could be due to a fungal infection known as Tinea corporis. This is quite common in normal healthy individuals. Excess moisture due to sweating, along with friction at these sites predisposes to fungal infections.
A fasting glucose level of between 100-125 mg/dL is considered prediabetes. If your glucose level of 108, estimated after an 8 hours of fasting period was 108, then you are considered to have prediabetes. If your test was a random glucose level, then your value is normal.
Prediabetes does not have any symptoms as such. Tingling of extremities due to peripheral nerve dysfunction and recurrent fungal infections can occur in overt diabetes, not prediabetes. However, this does not mean you have overt diabetes.
A prediabetes status means that you are at an increased risk of developing overt Diabetes in the future along with increased risk for coronary artery disease. However, with active intervention including diet control (low sugar and fat), regular exercise and targeted weight loss, this risk can be cut down or eliminated.
I would recommend that you take the following measures.
1. You can use the OTC antifungal 1% Clotrimazole (LotriminĀ®) cream, over the armpits and groin for 3-4 weeks. The affected areas should be kept dry (talcum can be used, even as a preventative measure). Also, avoid hot baths and tight-fitting clothing. You can wear boxer shorts rather than briefs. If the rash persists after 4 weeks, you can consult a Dermatologist for the same.
2. Please ensure that you take a highly nutritious balanced meal. Also, you can take Vitamin B12, 250 mcg, available as Ener-BĀ® [OTC] once everyday, for 3 months. This should take care of the tingling.
3. An OTC like Tylenol or Advil (should not be taken on an empty stomach) can be taken whenever the leg pain is unbearable.
3. If your glucose value was a fasting one, you need to take the above mentioned measures to lower your risk. You can discuss those when you see your doctor.
Thank you.


Dr. Deepu Sebin Sebastian
Category: Sexually Transmitted Diseases(STD)Specialist
Experience: 
MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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