[Question #4682] HIV negative but LOW CD4 COUNTS

26 months ago

Hello Mr. Handsfield or Mr.Hook.Hope you’re doing well.This is my second topic on this forum.I really need your professional help because i don’t know what should i do.


I had a protected sexual encounter with sex worker in Ukraine who has HIV+.I heard it after a long time later.(8 months).We had sex 2 times and i use condom both encounters.After second encounter,i saw just a little bit of blood on condom.There was not broke,damage on condom but i didn’t check very carefully.I clean myself on shower after i took off condom.I didn’t have any cut on my genital area.


Here is my tests ; 


39.day 4th gen.hiv duo ultra- neg.

57.day 4th gen. hiv duo ultra-neg.

108.day 4th gen. hiv combo-syphilis- neg. cmv igG pos. igM neg.

180.day 4th gen. hiv duo ultra-neg.

235.day 4th gen hiv combo-hepatitis c ,b negative, ebv igG positive (10.06) igG positive (1.36 low percentage)  

260.day 4th gen hiv combo neg., ebv igG pos. (6.96), igM pos. (1.09)

300.day HIV RNA PCR, hepatitis c RNA PCR negative


Everything looks good except ebv mono.But its almost negative too.I look like a over tested,right i understand but i got these tests because of my symptoms that still i have them.For example ;

Swollen and painful lymph nodes on neck, on armpits.They check it on ultrasound 7-9-10-11 mm’s since 6 months.

I have a sore in my mouth on my cheek,its without pain and red color.It looks like a licken planus or pemphigus vulgaris.

Sometimes i have a diarrhea and abdominal pain.

Sometimes i feel really tired and sleepy.


After all these symptomes still continue, i decided to have a CD4-CD8 count test.Here is results ;


CD4 = 473 (%34) , CD8 = 460 (%33.1), CD4-CD8 RATIO = 1.02 (0.60-2.80)  Lymphocytes 1391, WBC 6720 ,CD3 %74


-Why my hiv tests,even HIV RNA PCR tests are negative but i have a low CD4 count and low ratio ?

-Why i still have a symptoms? Due to hiv?

-What should i do with these low CD4 counts? Nobody believe me on my family and my doctor that i could have HIV because of these CD4 count and symptoms.

-Is there any explanation about that all symptoms,tests results,CD4-CD8 counts and ratio?

-Is it possible to i have a HIV with rare subtypes that HIV tests can’t catch it ?

-Am i be a seronegative person to hiv ?


Best Regards.. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome back, but sorry you thought it necessary.

Please re-read your other thread, which was very reassuring. You describe all the same tests results this time, and they prove you do not have HIV.

CD4 testing is not a test for HIV. It is never done in connection with HIV except in comeone with a positive HIV blood test, to help tell how damaged the immune system is. There is never a need for such testing in someone with a negative HIV test. CD4 numbers are highly variable; the results can differ by 200+ cells over the course of a single day. In rare cases, it may indicate an immune disorder other than HIV. Also, minor viral infections like a common cold can affect the count.

To your current questions:

1) "Why my HIV tests normal...but I have low CD4":  Because you do not have HIV. Anyway, your CD4 is not really abnormal. It is within the normal range, depending on time of day. Or maybe you had a cold when you were tested. The important thing is that you don't have HIV.

2) Your tests also prove your symptoms are not due to HIV.

3) "What should I do....?"  Probably nothing. If you remain concerned, see a doctor.

4) "Is it possible to i have a HIV with rare subtypes...?  No. There are no subtypes not detected with standard tests.

5) Yes you are seronegative and do not have HIV.

HHH, MD
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26 months ago
Mr. Handsfield thank you for your kind and fast answer.As you can guess,it's not really easy to overcome all this worries because as i said she was HIV+ and i saw a little bit blood on condom too and my symptoms added on all of that story, it's really hard to pass.I have a more questions too,i hope you are not going to be angry to me if i will repeat my questions again.I'll try to be don't repetitive.

-I check my previous CBC pages, i saw that my lymphocyte was high 2 years ago(2016) too.It was 3,5#.I had another 3 more CBC with HIV tests this year 2018,in one lymphocyte 3,5# again, other is 2,4# and last one with my CD4 count, 1391 lymphocyte.They decrease day by day.Do you think that is a dangerous sign or something? Should i repeat my CBC or CD4 count again?
-As you know internet is a big sea.However if you don't know how to swim, you will be choke.I gave this example because on the internet, there are lots of links about medical articles and i read almost all of them on this period.I saw 25 people can't produce antibody for HIV and 17 of them  detected by 4th gen. hiv tests or with HIV viral load.However the remaining 8 people, couldn't detect by 4th gen. tests or viral load test.Here is the link, could you please check it and response me about that? Because i really need your professional perspective.Sometimes i'm thinking that i'm a guy who is can't produce antibody or can't detected by HIV tests.That's why my CD4 counts decrease.I don't know this is an anxiety or reality.
-I saw some information on medical articles that some people with HIV, their virus are persisting on their lymph nodes and it show up very late more than a year.Is that possible ? Have you ever hear that?
-Have you ever seen any people's HIV can't detect on HIV tests for a long time, then it turns positive ?Is it possible ?
-I have a wife and we really don't have a sex without condom for a long time.I'm afraid to hurt her.Can we continue have sex without condom with no RISK for HIV?This is really important for me and for my marriage.
-If i come to you as a patient, tell my story and show my HIV tests,CD4 counts,my symptoms that still i have, what would you think ? What would you do about my symptoms?

Thank you Mr. Handsfield, hope you are not angry to me that i ask you this long questions.God bless you.
26 months ago
I forgot to send a link.Here it is.Please i need your information about that article Mr. Handsfield.

https://journals.lww.com/aidsonline/Fulltext/2010/06190/Seronegative_HIV_1_infection__a_review_of_the.2.aspx
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
You're expecting too much from thi forum. We are not a resource to diagnose the cause of your sympotms.

The article you site is irrelevant. It refers to rare HIV infected people with negative antibody tests. You were tested for antibody and also for HIV antigen and for HIV DNA. All the patients in that study were positive on these tests:  that's how their HIV infections were diagnosed so that it was known their antibody tests remained negative. So it's a rare phenomenon; and it doe's apply to your situation.

Lymphocyte counts naturally vary exactly as yours have. It's normal, not evidence of anything wrong at all. And no, I have never had a patient with negative HIV tests like yours who later had a positive test or other evidence they had HIV. With the kinds of tests you have had, THIS NEVER HAPPENS.

If you came to me as my patient, my reaction would be exactly as you have heard on this forum. You do not have HIV. Stop worrying about it. Do not have any more tests of any kind. Resume sex with your wife; you cannot infect her with HIV. If you continue to have symptoms that bother you, see a doctor.

Finally, no more questions about this on this forum. We cannot help further, and repeated anxiety driven questions on the same topic are not permitted.

If you have another final BRIEF comment, that DOES NOT ASK THE SAME QUESTIONS AGAIN, post it in the next day or two. At that time this thread, your last one on the forum, will be closed.
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26 months ago
Mr. Handsfield, thank you for you patience and answers.I have a final questions.I will be glad if you'll answer them with you patience again.

-As your answer ''All the patients in that study were positive on these tests:  that's how their HIV infections were diagnosed so that it was known their antibody tests remained negative. So it's a rare phenomenon; and it doe's apply to your situation.'' Your last sentence is '' and it doe's apply to your situation.'' you mean it doesn't or it does? Please forgive me if i ask a stupid thing but im not american and im trying to understand you write it wrong or right.

-My ex girlfriend call me maybe 6 months ago, after our last encounter and she said me to she has lots of hpv's inside of her vagina and she started to treatment for burning them and cream treatment.We all the time use condom, but i know hpv transmit with condom too.I'm a clean man,all the time im cutting a hairs on my body,i mean legs,torso,back,genital area and i never see any hpv on my genital area or penis.I just have lots of warts on my body.3-5 on both feet,1 on leg,1 on finger.I have them almost 2-3 years.I went to hospital to burn or freeze them,they did but it happens again and again.I'm thinking if i don't have hpv on my genital area,maybe my other warts for example on my feet or on my finger,touched her vaginal area, then she produce hpv too.Is it possible? What should i do to extinguish them till forever? Especially under my feet,after i burn or freeze,happen again 2 months later.Is there another treatment way to more effective?

-Is that warts, sign of a weak immune system? That warts started 2-3 years ago under my feet.But i know myself i'm not kind of person everytime get cold or sick.I'm doing gym,using supplements,no alcohol,no drugs or smoke.What do you think?

Thank you Mr. Handsfield,i trust you.You are a real man,God bless you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
DOESN'T apply. I think you knew that's obvious, but sorry for the typo.

Your exposure to genital warts and the possibility you have warts is really an entirely separate issue than HIV or your risks for HIV. Warts are not a sign of a weak immune system. If you would like to discuss and have our advice about the warts, you'll need to start a new thread. (My comments above about no new questions still holds for HIV, your HIV test results, etc. But of course it's OK to start a new thread on an entirely different topic like warts and HPV.)

That concludes this thread. Perhaps we'll hear from you again about your and past partner's warts.
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