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differential blood during priamry hiv

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During primary hiv,does a cbc with differential shows abnormalities? I know that this kind off test dos not detect hiv infection, but as well as I know during primary hiv t cells of the lymphocytes decrease from 1200 cells/mm3 to 500 mm/3 and never increase to baseline as before. I had a cbc with differential , it was a manual count, and i took this results:

8800 wbc
32% denny_lymphocytes that means 2816 of wbc are lymphocytes.this mean that half of 2816 are T cells

so if primary hiv decrease T cells that are components of lymphocytes, should lymphocytes be decreased too?

1-Based in these facts can I peace up my mind?
2-if I want to donor blood, will this blood be safe to other people?

thank you very much
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replied March 29th, 2011
Hello and thank you for posting your medical question on E health forum.

HIV infection is followed by initial lymphopenia (Decrease in lymphocytes) followed by lymphocytosis with atypical lymphocytes ; In later stages when the viral load increases, neutropenia, thrombocytopenia and transient pancytopenia can occur due to blood cell destruction by the viral replication.

The WBC count is the number of white blood cells in a cubic centimeter of blood. These cells prevent and fight infections. Normal WBC count is from 4500 to 11000. The 2 main type of WBCs present in blood in large percentages include neutrophils and lymphocytes. Lymphocytes are broken down mainly into CD4(+) cell and CD8(+) cells.

Progression of HIV is not evaluated based on the total WBC count. It is based on the estimation of the percentages of the CD4(+) and CD8(+) lymphocytes as well as the viral load estimated by the PCR for HIV RNA load test.

Normal CD4 counts are 350 - 1500 ; Normal CD8 cell counts is 275 - 780.

HIV causes a slow progressive decline in the number and percent of CD4(+) cells in most individuals.

Viral load monitoring can establish the patient's prognosis in HIV infection.

Rising viral load indicate disease progression;

Falling viral load, a favourable prognostic trend.

The progression of HIV in individuals varies. Some people progress in their disease rapidly and others don't seem to progress much at all after more than 12 or 13 years.

So based on the above facts, a person with HIV infection that is progressing moderately and not treated may have a lower total WBC count. And the percentage of CD4 (+) lymphocytes will be very low and the Viral load may be high. Such a patient will clinically have recurrent opportunistic infections like tuberculosis, candidiasis, etc.

In a HIV infected patient, with a strong immune status, the virus remains in a latent state, replicating at very low levels, and in such patients the Total WBC count may be normal, but it is never HIGH.

A WBC count hence cannot be used as a reference to whether a person is infected or not. Screening with HIV antibody tests would be neccessary to define the HIV status.

You may consider to consult a physician for additional information to clear any persisting doubts.

I hope this helps.


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replied March 29th, 2011
CD4 and CD8 during acute HIV
Thank you very much for your professional reply. Absolutely I know that WBC with differential does not detect HIV, all I wannted to know was if this kind off test indirectly can be helpful to understand something. During primary HIV ,CD4 and CD8 decrease , based on this as You told lymphocytes have to decrease too (lymphopenia) am I correct? We know that CD4 does never comes back in baseline, IF CD4 does never comes back in baseline will lymphocytes be in optimal counts like my test results, 2816 of lymphocytes, I recieved this count about 6 weeks post-expoasure, in this period of this time CD4 decrease to 500 cells/mm3.
1-is this logic correct?
2-if during this acute period of HIV( 6 weeks post-expoasure) when CD4 are to low and viral load to high ,can lymphocytes be normal?
Thank you very much for your time
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replied August 14th, 2013
I have The same question too. During primary HIV are lymphocytes high and neut low? What about monocytes? Are these high too on a primary HIV infection ?
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