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Unprotected sex and red dots on the back

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Hi doctor
I have had a sex with a lady with unknown history and it was unprotected sex this was last year may. After time a got seriously worried after I found some etchi red/ pink dots in my back side, I had flu after 2 months of that day and diahrria for three days. I went to the hospital and I test for all STD's and all found negative as my doctor said this could be syphillis, the result was negative for syphilis. I went to another doctor he said this is just a kind of allergy. After three months I have done full blood test including STD's ( compo p24 and anti body ) test was negative however, my white blood count was low 2.6 and the avg is 4 to 11. 4 months later test repeated and all results were negative and with low WBC. Same tests conducted after 6 months and all was negative with 3.3 avg of WBC. I got to know Elisa is best for HIV and I have done it after 6 & 8 months and were negative , dr.recommend for PCR and the result was not clear for me:
Results: < 20 Copies/mL
i.e. < 1.3 log copies/mL
i.e. < 34 UI/mL
i.e. < 1.5 log UI/mL
Interpretation: Threshold is estimated as 20 copies(1.3 log ) of HIV-1 RNA/mL of plasma. the linearity range up to 10000 00 copies/mL(log 7). The quantification Is homogenous For all sub Types of HIV group M and HIV-1 group O tested, but Is not applicable to HIV-2 . This test is exclusively Reserved for the Follow up Vairal load In HIV-1 serpositive Paitints.
I am seriously worried and I have the below questions:
1- does the low WBC is an indication of HIV, or does impact the test as the test can not detect the anti body because of low WBC ?
2- does the low WBC is an indication that my body fight with unknown virus and it could be HIV?
3- does the low WBC impact the window period ?
3- is the above conducted test enough or do we have to do another test ?

Please help me I am sooo tired ... I need answers all the websites are full of conflicting and confusing information ,
Thank you,

Category: Sexually Transmitted Diseases(STD)Specialist

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Category: Cosmetic and Plastic Surgeon
 23 Doctors Online

Hello,

Thank you for asking your query at DoctorSpring.

Your PCR tests have come back negative for hiv 1 infection as you are below threshold.You have a negative PCR, negative antigen, negative antibody, negative combo test - I would say you have the best possible proof in the world to say you are HIV Negative. So relax and take it easy.

1. Low WBC is not a significant finding. It is more commonly found in many commonly occurring viral infections. No, this will not affect the pcr tests as this is a test looking for actual gene copies of the virus in your blood plasma.

2. Unless you have a persistent low WBC count, less than 3500 you need not worry. Low wbc could be a result of a general viral infection or a blood disorder rather than HIV.

3. No, low wbc counts have no impact on pcr testing for gene copies.
4. Yes, the above tests are enough and you should accept the fact that you are not infected with hiv.

Hope I have answered all your queries. Please feel free to ask clarifications via followup questions.

Thank you


Patient replied :

Dear Dr kruti,

Thanks for your kind reply, just one more clarification :

Can the low WBC result impact Elisa test result , CIMA tests or window period in general ?
Just for more information my WBC for the last year is always between
2.6 till 4.0 avg is 3.4. The doctor recommend Peripheral smear and it was done witness no issue reported.

Thank you again


Hello again. A low wbc cannot affect the window period or test results of any of the above. Your wbc counts appear to be normal and understand that there are lower variations in some individuals that are still considered normal in this range. Be assured that this is not cause for concern for you. Take care and be well.


Patient replied :

I am so sorry doctor and please accept my last concern,.. Actually my WBC is low around 2.6 now just checked yesterday. It's always low after that incident and the report says its leukopenia and I searched in the internet and one major cause of leukopenia is HIV I got too much worried now than before, even I have tested HIV and it's (-) antibody test.. So please let me know if my result is considered final not need to worry or the leukopenia May impact the window period of the virus? Appreciate your kind support and understanding
Very very very sorry for this


Hello,

I would really surprised (and shocked) if the low WBC is due to HIV in your case. Since all tests are negative it is less likely. However low WBC if persistent need evaluation. You will need further blood tests and a Bone marrow study. I would keep HIV last in the list of possible diagnosis. Please get in touch with a Hematologist / GP for evaluation of the WBC count. As a first step repeat the test and get a Peripheral Smear done.

Hope this helps
DO feel free to ask followup questions.
Thank you


Patient replied :

Dear Dr , yes test was done and it's nigative Negative PB smear : leukopenia No animea with normocytic, normochromic RBCs. Normal PLT count Abnormal immature cells are not seen. WBC :2.6low (4-10) RBC: 5.08 (3.5-6) Hemoglobin:16(12.-17) Hematocrit: 45.3 (36-52) MCV: 89.3(82-98) MCH:31.4(26-34) MCHC:35.3(31-37) Platelet count: 194 (150-450) TSH: 0.78 (0.34-5.60) FreeT4: 0.78 ( 0.58-1.64) T3: 89(65-150) Retlculocyte count: 0.9(0.2-2.5) with high bilirubin 1.4 (0.1-1.2) I forgot to say that three days before the test I took a medication antiinflmation and antibiotics for the swallen lymph node near my ear. I read in the internet that leukopenia can be caused by HIV in addition I have always swallen lymph node near my ear at my nick. Do you believe doctor after all this time I might be HIV + as I said I have done several tests almost a year!! That's all doctor, I really now got worried I will appreciate if you can really explain it to me and provide me with your consultation


Hello, You need to get in touch with a Internal Medicine Specialist / Haematologist for evaluation. You have isolated low WBC with HIV negative. So it is better evaluated by an expert in the field.
Thank you


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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