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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    Will mononucleosis testing also show other bizarre readings for HIV?

HI, I AM CONCERNED about a recent mono diagnosis. The blood test came back positive for a very weak case of mono.....i got worried though after seeing some symptoms were similar to other worse diseases like hepatitis or even hiv when i looke donline...so i asked my dr if my blood test made him think there was a chance i had anythign worse...he said while the blood test i had wasnt for hiv, if i had that, he would have seen other bizarre readings from the mono test that would have set off red flags...is that true?
Mon, 9 Nov 2015
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Infectious Diseases Specialist 's  Response
Hi,

The signs and symptoms of many infectious diseases, caused by viruses, have many similarities. Please do not get carried away by such overlapping manifestations. There are specific tests that are available to confirm or rule out each of these conditions.

In your case, I understand your doctor has tested for infectious mononucleosis, which is a syndrome of sore throat, fever and lymphadenopathy, with atypical lymphocytosis. 80-90% of such cases are caused by Ebstein Barr virus, which is generally associated with a positive heterophile antibody test.

Your doctor is right when he said that he would have noticed other red flags if HIV was co-existent, or worse, HIV is the primary condition. For example, the blood picture in infectious mononucleosis is that of a peripheral lymphocytosis representing activated T cells responding to virus-induced B-cell proliferation. In HIV, this will be the exact opposite, wherein the lymphocyte count drops. I assume your doctor must have also ordered ‘Liver Function Tests’ which are markedly abnormal in infectious mononucleosis. Most importantly, your doctor must have probably seen a positive heterophile antibody test, which is characteristic of Ebsetin Barr virus. This test will be negative if the cause was HIV.

I conclude that you do not have to worry about HIV at all.
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