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Can Lymphocytes Fluctuate With HIV?

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Posted on Mon, 16 Oct 2017
Question: I went to the hospital mid August with a fever of 104. I had no rash indicative of a tick (or HIV ever for that matter) and no other symptoms, but the fever. My CBC WBC: 5.1 Neutrophils: 85% Lymphocytes 7%. Liver enzymes extremely high with the fever. I was admitted and everything negative in blood cultures other tests, etc except for some abnormalities in urine. They treated me with general antibiotics and antibiotics for tick. While in the hospital for 4 days my WBC fluctuated from 3.5 - 5.1 Infectious disease doctor said it was most likely a tick illness (even though no rash) or small chance urinary tract infection that went sepsis. My fever broke after 3 days (1 day upon starting doxycycline for tick) and within two days of ER visit my WBC was 4.5 Neutrophils 70% Lymphocytes back up to 20%. Blood work has ALL been normal since was pulled twice in September including my liver enzymes back to normal. I have not had sex in over a year so I'm not worried about ARS. I guess my question is if I were HIV positive and lymphocytes happened to be pulled down by HIV would they increase (triple) like that within two days? I didn't have high risk behaviors, don't use drugs, etc. was just going through a divorce a year ago and after googling thought what if he cheated. The Infectious Disease doctor said he was certain this was caused by a tick an didn't see a need to further investigate. The fever has not returned since I have left the hospital and have no other symptoms. Upon coming home from the hospital and seeing how low lymphocytes were I started "googling" wrong thing to do, but they have above 20% in three blood draws between mid august and now and liver enzymes back to normal and WBC always above 4.0. Doctors said I'm healthy and don't need to see me until January.


Blood work when I was admitted to the hospital compared to when I left

Admitted:
Wbc Count 5.60 K/uL
Rbc Count 5.03 M/uL
Hemoglobin 15.1 G/DL
Hematocrit 42.8 %
Mcv 85.1 FL
Mch 30.0 PG
Mchc 35.2 G/DL
Platelet Count 172 K/uL
Rdw 12.8 %
Mpv 9.2 FL
Neutrophils % 85.5 %
Lyphocyte % 7.0 %
Mono % 7.1 % 0.0 - 11.5 %
Eosinophils % 0.0 %
Basophils 0.4 %
Neutrophil Absolute 4.80 K/CU MM
Lymphocytes Absolute 0.40 K/CU MM
Monocyte Absolute 0.40 K/CU MM
Eosinophil Absolute 0.00 K/CU MM
Basophils Absolute 0.00 K/CU MM

Latest Blood Work one month later:
WBC: 6.0

Latest Blood Work one month later
WBC: 6.0
RBC. 4.40
HGB: 13
HCT: 39.5
MCV: 89.7
MCH: 29.5
MCHC: 32.9
RDW: 13.2%
PLT: 256
LY%: 20%
MO%: 5.7%
GR%: 74.3%
doctor
Answered by Dr. Ivo Ditah (31 minutes later)
Brief Answer:
WBC cannot change this much with HIV!

Detailed Answer:
Hi,

These results show nothing in favor of HIV. HIV WBC changes would not be pulled up easily. I understand your heightened concerns because of the risky sexual encounters but for sure this is not HIV. With no sex in over a year, every single HIV test is reliable and results final. Because you have never been diagnosed with any HIV up to this point, you certainly went unscathed through all the risky exposures/encounters.

I hope this clears your worries. I wish you well. Feel free to follow up with me if need be.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ivo Ditah (6 minutes later)
Just asking the Lymphocytes would not go from 7% to 20% in 2 days with HIV? I was assuming no but nothing online said that. The ID doctor told me he sees 200 people with HIV and my blood work was not conclusive of that in anyway and its just a tick bite infection. One internal medicine resident doctor in passing said to me "this could be HIV you have fevers and chills when it gets to 103". The ID doctor said she should of never said that and nothing suggests HIV. I may get tested for piece of mind, but no sexual encounters in a year and I'm assuming a high fever would be ARS not occur at one year from my research.

So Lymphocytes would not triple in three days due to HIV and me just receiving antibiotics?

Thanks for the peace of mind.

It wasn't suggested that I be tested for HIV by the infectious disease doctor at the hospital and my family doctor didn't think necessary either since everything normal and no sex in over a year with just one partner.

When I said all tests negative I meant for mono, typhoid, bacteria in my blood etc. But your opinion this illness not hiv related.
doctor
Answered by Dr. Ivo Ditah (8 hours later)
Brief Answer:
IT is not HIV related!

Detailed Answer:
Hi,

HIV cannot cause such rapid swings in WBC. YOU have nothing to worry about HIV.

I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ivo Ditah (17 hours later)
Thank you again. I would of never thought HiV until the internal med resident brought it up which was squashed by ID doctor and he didn't see a need to HIV test especially since I didn't have sex in over a year and symptoms weren't geared to that (only high fever). My family doc felt the same. 20% lymphocyte is on the low end of normal but is it possible that is my normal? I get blood drawn twice a year every year due to blood pressure meds and everything is always good. If HIV was making me sick it would show after a year in blood work I assume. Thank you for the peace of mind and I need to enjoy my health and happy my fever went away from antibiotics and hasn't returned. Have a good weekend.
doctor
Answered by Dr. Ivo Ditah (31 hours later)
Brief Answer:
Have a good weekend and enjoy your life!

Detailed Answer:
Hi,

HIV is not only and extreme but far from a possibility. Relax, take control of your life and live it to the best.

I wish you well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ivo Ditah

Internal Medicine Specialist

Practicing since :2002

Answered : 3993 Questions

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Can Lymphocytes Fluctuate With HIV?

Brief Answer: WBC cannot change this much with HIV! Detailed Answer: Hi, These results show nothing in favor of HIV. HIV WBC changes would not be pulled up easily. I understand your heightened concerns because of the risky sexual encounters but for sure this is not HIV. With no sex in over a year, every single HIV test is reliable and results final. Because you have never been diagnosed with any HIV up to this point, you certainly went unscathed through all the risky exposures/encounters. I hope this clears your worries. I wish you well. Feel free to follow up with me if need be.