Acute HIV Oral Symptoms, CBC Irregularities

Originally Posted: 
Saturday, March 31, 2012
Question: 

Hi, 

 
I want to thank you from the bottom of my heart for providing this service. I’m a 30 year old drug-free heterosexual male. 6 weeks ago I began showing ARS like symptoms. Night sweats, fever, and oral ulcers (very large canker sores, thrush, inflamed papules on the tip of my tongue, and recurring geographic tongue). After 3 weeks my night sweats mostly disappeared, as did the canker sores, and thrush, but the inflamed papules and geographic tongue persisted and fatigue and general weakness and heart palpitations set in. Also, five weeks after symptoms began I began noticing recurring blood red spots (dark red/purple) that come and go on the inside of my mouth cheeks. I’ve never had more than 3 at once. They’re 1mm or less in diameter and can appear suddenly within an hour and usually fade and disappear within a day or two. 
 
I was tested for Hep A,B,C, HIV and other STDS. All negative. My most recent HIV test, a rapid antibody test, was taken 33 days (4.5 weeks) after symptoms began (a little over 5 weeks after my most recent unprotected sexual exposure). The result of the 4.5 week HIV test was negative.
 
Finally I had a CBC about 3 weeks after symptoms began and again about 5 weeks after symptoms began. The first CBC (after 3 weeks of symptoms) came back with no irregularities.  The second CBC (after 5 weeks of symptoms) showed:
 
LOW Counts:
 
LKCS (White blood count) of 4.1 (normal=4.8-10.8)
ERCS (Red blood count) of 4.63 (normal=4.7-6.1)
Lymphocyte of 1.4 (normal 1.5-4.0)
 
High Counts:
MPV of 10.5 (normal=7.4-10.3)
 
Low end of normal counts:
Neutrophyl of 2.3 (normal 2.0-7.5)
 
My risks for HIV were about 5 incidents of unprotected vaginal sex with 4 women (none of whom are known to have HIV), over the last 4 months (the most recent being just 5 days prior to falling ill with symptoms). 
 
I'm terrified with fear about HIV. 
 
1. How reliable (trustworthy) is my most recent test (after 4.5 weeks of symptoms)?
 
2. My symptoms have persisted for an unusually long time for ARS. Do oral symptoms of Acute HIV have a tendency to persist longer than other symptoms? 
 
3. Do CBC irregularities caused by Acute HIV tend to show up during the initial weeks of symptoms, or do they generally appear later, in the weeks following the disappearance of symptoms? 
 
4. Are my CBC irregularities and symptoms atypical for HIV? How concerned should I be about HIV at this point?
 
I greatly appreciate any insight you can share with me. 
Answer: 

Hi there and thank you for using AIDS Vancouver as your source of HIV/AIDS related information.

First off, it is great to know that you have been tested for both HIV and other STIs as it is the only way to know your status. But considering that we here at the AV Helpline are by no means medical professionals or physicians, I will be unable to make an accurate diagnosis of your symptoms. Though, I will try my best to answer your questions and provide you with the necessary information.

Also, it is important to note that HIV symptoms or ARS (acute retroviral symptoms) often mirror the symptoms of other viral infections (e.g. flu, mono, etc), so attempting to determine one's HIV status through symptoms is difficult and often times not favorable as it can lead to anxiety. Again, the only way to know your status is by receiving an HIV test.

 

1) How reliable (trustworthy) is my most recent test (after 4.5 weeks of symptoms)?

With a rapid (or "point-of-care") test, it detects for antibodies and the window period for antibody detection is between 4-12 weeks. So, seeing that your last unprotected sexual encounter was 5 weeks, without measuring the time since your symptoms, your results are considered reliable but not conclusive. Up to 95% of HIV infections are detectable within 4-6 weeks. But still, it is a good indicator of your status. As suggested by international HIV guidelines and most HIV specialists, an HIV retest should be received again at or after 12 weeks for your results to be considered conclusive. However, here at the AV helpline, we have never seen a negative result change to a positive one.

2) My symptoms have persisted for an unusually long time for ARS. Do oral symptoms of Acute HIV have a tendency to persist longer than other symptoms?

Like I stated previously, HIV symptoms usually mirror other viral infections which means they could vary, be more or less severe, or may in fact not occur at all. But if they do happen to occur, they usually only occur 2-6 weeks after infection and typically only last a few days, if at all. Seeing as you have already received a negative HIV test result and have been tested negative for other STIs, the only thing I can advise you to do would be to consult your doctor or a healthcare professional as they are able to accurately diagnose your symptoms.

3) Do CBC irregularities caused by Acute HIV tend to show up during the initial weeks of symptoms, or do they generally appear later, in the weeks following the disappearance of symptoms?

Your CBC (complete blood count) results cannot be used to determine your HIV status at all. Generally, in the way HIV infection progresses, there would be a slight decline in your CD4 count during the initial weeks but usually spikes back up before gradually declining again if one is not receiving medication. But your CBC is not an accurate or reliable way to determine an HIV status as underlying causes may be the result of CBC irregularities. It must be remembered that our bodies are always fighting off infections so white blood cells in particular may fluctuate from day to day or week to week. 

4) Are my CBC irregularities and symptoms atypical for HIV? How concerned should I be about HIV at this point?

Again, I am not a medical doctor so I am unable to read you CBC, but from what I can gather, I do not think you should be concerned as you have already received a negative HIV test result which is definitely a good predictor of your status. But, I would advise that you receive another HIV test at or after 12 weeks if this still concerns you as it will provide you with a conclusive result.

 

Please feel free to email or call us if you have any further questions.

In Health,

Darrien
AIDS Vancouver Helpline Volunteer
E-mail: helpline@aidsvancouver.org
Phone (Mon-Fri 9-4pm): (604) 696-4666
Web: www.aidsvancouver.org/helpline

Comments

Submitted by Marquita (not verified) on

I have unexplained bruising that are dark red and light purple, their about the size of a quarter on upper thighs and upper arm, they come in go within days or weeks. It's been going on for about a week after possible exposers to an infected partner what could thi be?? Am I sick!!!!!!

Submitted by monicaf on

Hi there,

Thank you for using the AIDS Vancouver Online Helpline as your source of HIV/AIDS related information.

I have not heard of bruising being a symptom of early HIV infection, and additionally, HIV is never diagnosed based on symptoms. Testing is the only way to know your HIV status, so I would encourage you to get tested. You don’t mention specifically whether the possible exposure happened a week ago, or if that is when the bruising began, but any HIV test will provide you with pretty accurate results when it is done 4 weeks after a possible exposure.  At 12 weeks/3 months the test results would be conclusive. However, frequent and severe  bruising can be a sign of a variety of health problems, so I encourage you to ask your doctor about this.

If you have any other questions, please feel free to respond to this post.

In Health,
Allison
AIDS Vancouver Helpline Volunteer 

Submitted by Trini (not verified) on

On December 1st I had sexual intercourse with a long time friend. We had unprotected oral sex (me to him) and protected vaginal sex. The condom slipped off and he pulled out of me. He used his finger to retrieve the condom from inside me. This happened on December 1st.

Five days later on December 6th, I came down with a horrible cold. I was coughing up thick mucus and sneezing a lot. What worries me the most though is the dizziness. I've never felt anything like it before. It was severe to the point where I couldn't stand up without holding on to something. I had to crawl to the bathroom with my eyes closed. My eyes were feeling extremely sensitive and I couldn't look at the tv or computer screen because it was too bright. I had to squint to look at anything. Everything was kinda blurry and even when I was lying down the room was spinning. Then came the vomiting. Every single thing I ate came back up. At first I thought I was pregnant but numerous pregnancy tests confirmed that is not the case. I lost my appetite for the duration of this sickness which ended on the 16th of December, and have discovered that I have lost 10 lbs (though I'm not sure the weight loss occurred before or after the sickness since I haven't weighed myself in months).

On the 20th of December, my neck started hurting. It was sore for about two days and a bit stiff and now I feel sharp short pains throughout my body. These pains shoot through my arms, legs, fingers and neck. I have no swollen lymph nodes (although admittedly I don't know what a swollen lymph node looks like), and I didn't get any fever or rash. What I'm experiencing now is annoying muscle twitching even as I type this, a muscle in my neck is twitching and I've been feeling these muscle twitches all over my body that I don't think I've ever experienced this much before.

So now I'm thinking that this guy gave me something, and started googling and my symptoms sorta match ARS and mono. I asked the guy when last he had an HIV test and he told me 3 months ago for his job and it was negative but at this point I don't believe anything. So I guess I'm asking if anyone here can enlighten me (I'm not looking for a diagnosis), just some opinions on if what I'm experiencing sounds like it's ARS. Sorry if this is too long, but any feedback would be appreciated. Thanks.

I should probably also add that the condoms we used were lambskin and not latex since I have a latex allergy. I have heard that lambskin condoms are not effective against stds. We also had sex a total of 3 times that night. I scheduled an appointment to see my doctor on Monday but will an HIV test then be reliable as only 4 weeks have passed since possible exposure?


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The AIDS Vancouver Helpline is a volunteer-driven information, referral and support service related to HIV and sexual health. Volunteers are trained in active listening, HIV and sexual health information, and local resources and services. Volunteers are not doctors, nurses, or other licensed professionals. Volunteers do not give advice, and strive to provide service-users with adequate information and appropriate referrals.

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