[Question #10712] Same exposure new concern

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20 months ago
Based on my previous question what is the likelihood of contracting HIV? Friend is circumcised… and I recently had cbc with deferential done that showed normal WBCs- including lymphocytes, neutrophils, and the other ones all in normal range. If HIV had been acquired would the WBC and breakdown be abnormal? 
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H. Hunter Handsfield, MD
20 months ago
Welcome back, but I'm sorry you found it necessary. I'll be taking your question this time, but I reviewed your recent discussion with Dr. Hook and agree with all he said.

Oral sex is extremely low risk for HIV; and from my understanding of your partner, there is very little chance he has HIV. Do you have reason to suspect he's at high risk? Like injection drug use, sex with men, past incarceration? But even in the chance he has HIV, the approximate risk of transmission by performing oral sex (fellatio) on a male -- i.e. for penis to mouth transmission of the virus -- is around once for every 10,000 exposures. That's equivalent to giving BJs to infected men once daily for 27 years before infection might be likely. If we assume there's say one chance in a thousand he had HIV, the odds become one chance in ten million you were infected.

New HIV infection has little if any effect on CBC results.  Your normal result neither increases nor reduces the virtually zero risk you acquired HIV.

So you should not be at all worried, and from a risk standpoint, I see no need for HIV testing. Of course you are free to be tested anyway if you wish:  some people are more reassured by negative test results than by professional analysis and advice, no matter how expert. (We don't take it personally!)

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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20 months ago
Thanks, no further questions 
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H. Hunter Handsfield, MD
20 months ago
You're welcome. I'm glad to have helped. I'll leave this open for another day or two in case something comes to mind.---
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20 months ago
Thank you for keeping this open. I agree testing is not warranted based off of youre reply, as he is not high risk. My question is at what point will HIV affect WBCs? Would other symptoms show before labs are affected such as rash, yeast in mouth… 
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H. Hunter Handsfield, MD
20 months ago
Advanced HIV infection (overt AIDS) and the resultant infections (pneumonia, certain kinds of meningitis, and many others) will often be accompanied by changes in WBCs. Early HIV infection (acute retroviral syndrome, i.e. ARS) does not usually result in CBC/WBC abnormalities regardless of the symptoms in causes. In anyone who is outwardly well, no changes are expected regardless of duration of HIV infection. There is no point in CBC or WBC testing in your situation. (And in general, WBC testing is useless for health screening and not recommended routinely for that purpose.)

That will conclude this thread. I hope the discussion has been helpful.
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