Question:

Dear Doc,

I realize that a CBC [complete blood count] cannot detect HIV infection, however, the question I have is that if one were infected w/HIV wouldn't the CBC indicate a problem? By showing low RBC [red blood cell count] or High WBC [white blood cell count]?? Or lower Hematocrit levels? Again, not detecting HIV, but showing some sort of abnormality?? I have had many CBC's done and have never shown any indication of infections or abnormal results outside of elevated cholesterol due to eating habits. I had an encounter with an HIV + person about 4 years ago and don't want the stress of an HIV test, so I've relied on my CBC's to tell me if there are any problems.

All I want to know is if I come back with a clean bill of health on my CBC's, isn't that a pretty good indication that I am negative?? I haven't had any signs of infection, and was protected during my encounter w/ the postive person.

Signed,
NO Test for me

Answer provided by:

Peter Shalit, M.D.
Internal Medicine

Dear NTFM,
A normal CBC does not nessarily prove that you do not have HIV infection. It is true that in folks with HIV, it is not uncommon to see a somewhat low white blood cell count. Specifically, the type of white blood cell known as lymphocyte may be low. Less commonly, we see a low red blood cell or platelet count. If your CBC had any of these abnormalities, it would be a clue that an HIV test might be a good idea. However, there are plenty of people with HIV who have a normal CBC.

I understand that it is stressful to get an HIV test. However, knowing the answer is usually less stressful than not knowing.

Take care,
Peter Shalit

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