[Question #8300] HIV and STD Concerns

46 months ago

Hello, firstly I just wanted to thank you for your services with this website it's extremely helpful.

I had an unprotected anal sex (bottoming) with an unknown status stranger and did a 30 day PEP regimen and tested for HIV 6 weeks after the meds which was negative. All other STDs have been negative thus far. However, during this time I've had CBC bloodwork done several times for other reasons and I've had a consistent high WBC count and abnormal CBC which was previously normal, which concerns me that it could be related to HIV. These were the abnormal lab work:

10 days after exposure WBC- 12.4 Neutrophils- 9.1 Immature Granulocytes- 0.08

12 days after exposure WBC- 15.2 Neutrophils- 13.4 RBC- 4.25 Hemoglobin-12.8 Hematocrit- 36.9 Immature Granulocytes- 0.05

17 days after exposure WBC- 11.1 Neutrophils- 7.3 Hemoglobin-13.2 Hematocrit- 38.6 Immature Granulocytes- 0.06

10 weeks after exposure WBC- 11.4 Neutrophils- 8.8 Immature Granulocytes- 0.05

12 weeks after exposure WBC- 11.8 Monocytes- 1.0

14 weeks after exposure WBC- 12.3 Neutrophils- 9.0

Does any of this bloodwork with high WBC indicate HIV should still be a concern?

46 months ago

I also wanted to add my Bilirubin has been consistently high ranging from 1.4-1.6 during this time which was previously normal as well.

H. Hunter Handsfield, MD

46 months ago

Welcome to the forum. Thanks for your question.

In evaluating possible new HIV infection, CBC is entirely irrelevant. It should not have been done, assuming HIV was your only concern. (Or the concern of a health care provider who has been ordering these tests, although I'm guessing you're doing them on your own, right?) In regard to HIV, the important information is that you have tested negative 6 weeks after completing PEP. Assuming that was an antigen-antibody (AgAb, i.e. 4th generation) blood test, it shows for sure you were not infected. Some experts recommend a final test 3 months after completing PEP, but that's really just excessive caution. You can be sure you do not have HIV.

Going back to your CBC: First, your counts are barely elevated, except for the 12 day test at 15.4. The others are barely outside the normal range, and some people just run high normal values like these, so most likely nothing is wrong. Second, you don't show the lymphocyte count. New HIV infection can result in elevated lymphocyte counts, but so can any number of viral infections. In general, neither HIV nor other viral infections raise the neutrophil count. new HIV infection does not tend to elevate the WBC count. You also don't mention your red cell results (hematocrit, hemoglobin, RBC count) or platelet count, which can aid in interpretation of CBC results.

But for sure HIV isn't the problem, and no other STI is a potential explanation either. If you're seeing a physician, discuss these tests with him or her. If not, find a doctor now then follow his or her advice. However, this forum is strictly limited to issues related to HIV and other STIs, so there's nothing more I can say about all this. But I do hope these comments are reassuring about HIV and otherwise useful to you. Let me know if anything isn't clear.

HHH, MD

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46 months ago

Thanks for the response, the only abnormals I had with red blood cells were on 12 days and 17 days post exposure, which I posted in the first post, which I believe were low, along with a consistent high Bilirubin ranging from 1.4-1.6 during this time.

Does this change your opinion regarding HIV with the low numbers for red blood cells?

I also wanted to ask about a urinary problem I've been dealing with for around a year in a half which seems to have started right around after an unprotected encounter I had with a CSW. I've tested negative for all STD's after it but am really suffering from a constant need to urinate. I feel the urge to go every hour and it's especially bad during the night going every 30 minutes, sometimes even right after I pass urine even if it's a small amount. I have seen urologists and and have tried OAB meds which don't seem to help. Urinalysis has been normal. There is no burning when I pee, just a constant urge to go and feeling very uncomfortable if I don't even if it's a small amount. I also seem to dribble in my underwear. I concern it could be NGU from the encounter and I have some sort of infection bacteria causing this or that it's prostatitis. I haven't been on any antibiotics to treat this and I wonder if that could fix the problem if it's STD related.

Could this be NGU or chronic prostatitis?

H. Hunter Handsfield, MD

46 months ago

I forgot to comment on your bilirubin result -- sorry. There are several potential causes of mildly elevated bilirubin. Some are inconsequential, but others are serious.

The urinary symptoms you describe do not suggest any STD, including NGU. (As it happens, my forum colleague Dr. Hook was the senior researcher on one of the main studies showing that symptoms like yours are rarely if ever associated with any STI, including NGU.) I agree they are typical for OAB, but similar symptoms can occur with prostatitis, or with genitally focused anxiety or the male chronic pelvic pain syndrome (CPPS, the newer terminology for chronic non-infectious prostatitis). All I can do is suggest you continue to follow up with your urologist, who is in the best position to further evaluate these possibilities and manage your symptoms.

And no, none of this changes my confidence that you do not have HIV, which is not responsible for your various symptoms and problems. The elevated bilirubin and your mildly abnormal CBC results are not necessarily related, but it may be possible. Whether or not, but both of these need comprehensive medical evaluation. If you're not in the care of primary care physician or internist, I recommend you set that up soon.

This forum is limited to STD and HIV issues, neither of which is in play here -- so I really don't have any further advice about it.

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H. Hunter Handsfield, MD

45 months ago

I understand you asked that this thread be reopened. Threads are closed after 4 weeks or two follow-up comments and replies, whichever comes first. This one hit the 4 week mark. If you need further clarification, please post it in the next 24 hr. Also note that follow-up comments/questions are intended for clarification or uncertainties in regard to the original question, not for a new topic, exposure, symptoms, etc. Thanks!---
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