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Does the lymphocyte count reduce in HIV infection?

Dr Shirish Kumar
Haematologist,
WHO,
Geneva

Q: I had paid sex almost 12 years ago and that was the first time I had sex and ejaculated very soon. Till now I have had no such problem but my tests revealed a decrease in the lymphocyte count. Some 4 years back, it was 28% and now it has come down to 17%. I am worried as I had heard that in HIV, the lymphocyte count reduces. Please tell me what are the chances of me getting HIV infection?

A:HIV disease is a continuum of progressive damage to the immune system from the time of infection to the manifestation of severe immunologic damage, which is marked by opportunistic infections, neoplasms, wasting, or low CD4 lymphocyte count. Once HIV enters the body, the immune system starts to produce antibodies and their presence is used to tell whether a person has HIV. Most HIV tests look for the HIV antibodies rather than looking for HIV itself. Most people will develop antibodies to HIV within 3 months after infection. The average time it takes to develop antibodies to HIV is 25 days. In rare cases, it can take 6-12 months. There are tests that look for HIVs genetic material directly, but these are not in widespread use. The measurement of the number of viral copies per millilitre of peripheral blood (viral load) is done using polymerase chain reaction (PCR) or nucleic acid sequence-based amplification (NASBA) of the viral source or branched DNA amplification (bDNA) of the signal that can detect virus down to a few hundred copies per millilitre. The CD4% and TLC vary considerably within population with CD4+ % ranging from 4 to 48%. Get yourself examined by a physician and get tested for HIV antibodies (if advised). It is unlikely for you to be suffering from the disease after 12 years.