HomeAnswersHIV/AIDS specialisthivDoes HIV cause low WBC?

My WBC is very low when compared to the value taken two years back. Is this normal?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Preetha. J

Published At November 6, 2020
Reviewed AtAugust 1, 2023

Patient's Query

Hi doctor,

I apologize at the beginning of the long description (just trying to be more descriptive to get the right answer). I am a 35-year-old male who had unprotected sex eight months back. I had no symptoms at all, but the next month I started to have some fears about HIV, so I had an Instant HIV (Human Immunodeficiency Virus) test (HIV 1 and 2 and P24 antigen), and the result was negative. By the end of that month, I started to have a sore throat (without fever or any other symptoms), resolved after two or three days. Still, it was recurrent several times during the next two months with no signs. Still, the difference is I was sweating during sleeping at night from my back, which was making the bedsheet wet (I am not sure if this is because of the blanket because I was feeling hot, and when I take out the blanket, the sweating reduces immediately) so the fear of HIV was back again. I bought the HIV home test from the pharmacy, which is called the "Biosure HIV home test," which is CE marked (the pharmacist told me EU standards certify it) and performed the test five months back, and it was negative. Everything was fine, and I was following a sugary diet (just eating lots of chocolates). In the next month, I started having pain in the gum on one of my teeth, and soon the problem reached my ear (on the same site where I had tooth inflammation), and I had an upset stomach. The ear pain, upset stomach, and tooth pain were resolved in two or three days, but the inflammation if the gum did not resolve, and I noticed white hairy tongue (candida) was starting in the tongue. I was worried again about HIV, so three months back, I did an HIV CMIA(Chemiluminescent Microparticle Immuno Assay ) test (laboratory test), and the result was negative. The same month (one day after the HIV CMIA test), I decided to do a Biosure HIV home test, and the result was also negative. I had some concerns that the nurse did not use a brand new needle (when I did the HIV CMIA test), and I was so worried, but the medical team and a counselor assure me that it is impossible that the nurse used a dirty or used needle to draw blood. Eventually, the gum inflammation increased a lot in that tooth, and the candida on my tongue (white hairy tongue) was getting more and more. At the beginning of the sixth month, I started to have swollen lymph nodes under my jaw (same side of the inflamed gum). I went to the dentist, who prescribed antibiotics for a week to solve gum inflammation (note that I had the candida on my tongue before starting antibiotics). After a week or a bit more, the gum inflammation is almost gone, and several weeks afterward, the swollen lymph node was shrinking. My fears went so high in all cases, and I asked the counselor I want to repeat the HIV test. He agreed after I pressured for the test, so on the seventh month after the exposure, I did the HIV CMIA test again, and the result was negative. The counselor asked me to go to a GP or a skin specialist doctor to see the white hairy tongue. I went to the skin specialist doctor, who prescribed a topical antifungal medicine that will be used for two weeks. After two weeks of using topical medicine, the candida did not go away (even did not decrease). As a result, I was worried, so I did one more Biosure HIV home test in the eighth month, and the result was negative. I told the doctor that the candida is not resolving, so he prescribed Fluconazole 150 mg for six weeks (one tablet per week). It is now the third week, and the candida is still there (almost as it is) in my tongue (I still have while hairy tongue). The doctor did a complete blood count (CBC analysis), and the count of white blood cells (WBC) count was 6700. Today I compared an old CBC (Complete Blood Count) test I did a long time ago two years back (from my medicate journal and other medical reasons not related to STDs), and the WBC count was 8700. One more thing to mention is recent, I am also having (from time to time) a redness rash under my lower lip (in the corner), but I am not sure if this is because of the winter. Sometimes, different parts of my gum or tooth get in mild pain, and they resolve after a short time. This is recurrent. Note: I do not have diabetes, I do not drink alcohol, I do not smoke, and I do not take any medication. Please tell me: Can I be sure that the candida started on the fifth until today is not because of the weakened immune system caused by HIV (because the dentist told me the candida on the tongue is because of the weakened or low immune system)? Is it normal that the WBC count taken two years back was 8700, and last month which was 6700? I mean, is not this decrement of WBC considered as HIV weakens the immune system? As I describe previously, I summarize the several HIV tests I did: Instant HIV test (HIV 1 & 2+ P24 Antigen) after 31 days. Biosure HIV home test (CE marked) after 100 days. HIV CMIA laboratory test (antibody and antigen) after 159 days. Biosure HIV home test (CE marked) after 160 days. HIV CMIA laboratory test (antibody and antigen) after 202 days. Biosure HIV home test (CE marked) after 243 days. All of these tests were negative. Can I be sure and consider this is conclusive? I read on the internet that some doctors said for others to wait for a complete year after exposure to be sure about the HIV window period. As I do not drink alcohol, smoke, and do not take any medications or medicines, the immune system may respond to take one year to start producing antibodies against HIV? Is it the case? I apologize again for the long message. Please help me.

Hi, Welcome to icliniq.com.

The answers to your queries are: It is not an unusual scenario to see a more extended time clearing candidal infection in normal healthy individuals. For your present infection, I suggest taking, Tablet Flucon (Fluconazole)150 mg once a day for ten days regularly. This should be followed by once a week tablet for one month. Local application of Candid (Clotrimazole) lotion eight hourly for seven to ten days. Chlorhexidine mouthwashes twice daily for seven to ten days. Your WBC (white blood cells) counts are in the normal range at both times. Again nothing to worry about. There are so many technical reasons for variations in the laboratory values, calibers of machines, etc. Now, for the main issue, your HIV tests will be considered conclusive if there is no further exposure. The recommendations are to get a confirmatory HIV antibody test at three months. If the result is negative and no additional exposure, there is no need to get the test repeated. Your result will be considered conclusive in that case. You can surely relax and rely on reports (provided tests are done in an accredited laboratory) if there is no further exposure. My suggestions in your particular case would be to get tested for following and revert with reports. Repeat Complete blood count with ESR (erythrocyte sedimentation rate) after a week of antifungal completion. LFT (liver function test) serum creatinine. Fasting blood sugar. HbA1C (glycated hemoglobin). Thyroid profile. Serum Vitamin B12 and D3 levels. HBsAg (Hepatitis B virus surface antigen), Anti HCV (hepatitis C virus), VDRL (venereal disease research laboratory), Herpes simplex 1 and 2, PCR (polymerase chain reaction) for gonorrhea, if not done earlier for excluding other STIs (sexually transmitted infection).

Best wishes.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ravinder K. Sachdeva
Dr. Ravinder K. Sachdeva

HIV/AIDS specialist

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