HIV/AIDS Treatment HIV and Your CBC A complete blood count is routinely done to monitor for infections and gauge your response to treatment By Mark Cichocki, RN Updated on April 11, 2023 Medically reviewed by Latesha Elopre, MD, MSPH Print Table of Contents View All Table of Contents White Blood Cells Red Blood Cells Platelets A complete blood count (CBC) is a test routinely performed for people living with HIV to monitor for signs of other infections, assess the response to treatment, and identify drug side effects like anemia. A CBC measures the number and proportion of red blood cells, white blood cells, and platelets in your blood. It is one of several blood tests routinely performed when you are on antiretroviral therapy, alongside a CD4 count, viral load, liver function tests, and kidney function tests. The article explains how a CBC is used to manage HIV, including what high and low values of each type of blood cell mean. Illustration by Julie Bang for Verywell Health White Blood Cell Count A white blood cell (WBC) count is one of the tests included in the CBC. White blood cells (leukocytes) are a type of blood cell produced by bone marrow, the spongy, blood vessel-rich tissue in the center of bones. They primarily fight infection, and the different types play different roles in your immune function. A WBC count provides the total number of leukocytes in a sample of blood, as well as a breakdown of the amount of each type, including: Basophils Eosinophils Lymphocytes Monocytes Neutrophils Normal WBC Count White blood cells are measured in cells per microliter of blood (cells/mL). A normal total WBC count is generally defined as:Children: 5,000 to 10,000 cells/mLAdult females: 4,500 to 11,000 cells/mLAdult males: 5,000 to 10,000 cells/mL Because your body will produce more white blood cells whenever faced with a threat, a high WBC count may be a sign that your body is fighting an infection. With that said, an increase in different types of white blood cells can mean different things. For instance, a high eosinophil count may suggest a parasitic infection like toxoplasmosis, while a high basophil count may suggest an adverse reaction to a drug. On the other hand, a low WBC count suggests that something is affecting the bone marrow's ability to produce white blood cells. This may be due to certain medications used to treat HIV infections, like Zirgan (ganciclovir), or a potentially severe condition like tuberculosis or B cell lymphoma. Why Can't I Get My CD4 Count Up? Red Blood Cell Count A red blood cell (RBC) count is used to measure the total number of red blood cells (erythrocytes) in a sample of blood. These cells are responsible for transporting oxygen to the cells and tissues of the body. Other values measured as part of the RBC include: Hematocrit: The percentage of blood taken up by red blood cells Hemoglobin: The amount of hemoglobin, a protein in red blood cells, that is responsible for carrying oxygen molecules Normal RBC Count RBC counts can vary by the altitude you live at. A normal RBC count is generally defined as:Children: 3.8 to 5.5 million cells/mLAdult females: 4,2 to 5.4 million cells/mLAdult males; 4.7 to 6.1 million cells/mL A low RBC count is a sign of anemia, a condition in which you lack enough red blood cells to carry sufficient amounts of oxygen to tissues. A low hemoglobin count can also cause anemia. Anemia is a common side effect of the antiretroviral drug Retrovir (zidovudine) and the combination drugs Combivir (zidovudine/lamivudine) and Trizivir (zidovudine/lamivudine/abacavir). Anemia can also be caused by opportunistic infections like cytomegalovirus (CMV) or Kaposi sarcoma (KS). An abnormally high RBC count (polycythemia) is uncommon with HIV infection. With that said, people on testosterone replacement therapy for the treatment of HIV wasting or HIV-associated hypogonadism will often have a higher-than-normal RBC count. Platelet Count Platelets (thrombocytes) are colorless blood cells involved in blood clotting. Normal Platelet Count A normal platelet count can decrease as a person ages. In adults, it is generally defined as:Children: 150,000 and 400,000 cells/mLAdults: 150,000 and 400,000 cells/mLPlatelet counts are considered low when they are under 50,000 cells/mL. Platelet counts are rarely so high as to cause health problems. Low platelet counts (thrombocytopenia), on the other hand, can lead to easy bleeding or bruising, and, when severe, life-threatening internal bleeding. Thrombocytopenia is associated with chronic (long-term) HIV infection, primarily in people with advanced disease who are not yet on treatment. Low platelets can also occur with acute (early) HIV in 10% to 15% of cases. Certain antiretroviral drugs like Fuzeon (enfuvirtide) can cause low platelet counts, as can certain opportunistic infections like CMV and mycobacterium avium complex (MAC). Starting antiretroviral therapy can generally reverse thrombocytopenia and normalize platelet counts. Summary A complete blood count (CBC) is a panel of tests routinely performed on people living with HIV. it measures the composition of white blood cells, red blood cells, and platelets in a sample of blood. Changes above or below the normal range of values may be a sign of an infection or drug toxicity. Based on the results of a CBC, a doctor can investigate the possible causes of high or low blood cell counts, ideally before a condition turns serious. HIV Doctor Discussion Guide Get our printable guide for your next doctor's appointment to help you ask the right questions. Download PDF Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Email Address Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. HIV.gov. Lab tests and why they are important. MedlinePlus. WBC count. Huson MA, Hoogendijk AJ, de Vos AF, Grobusch MP, van der Poll T. The impact of HIV infection on blood leukocyte responsiveness to bacterial stimulation in asymptomatic patients and patients with bloodstream infection. J Int AIDS Soc. 2016;19(1):20759. doi:10.7448/IAS.19.1.20759 Chou A, Serpa JA. Eosinophilia in patients infected with human immunodeficiency virus. 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By Mark Cichocki, RN Mark Cichocki, RN, is an HIV/AIDS nurse educator at the University of Michigan Health System for more than 20 years. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit