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Do people without HIV, but with NHL have low CD4's? Timing of diagnosis
Mar 16, 2001

Dr Dezube,thank you for your valuable time helping people with HIV/AIDS.You certainly have a place in heaven.My question is this my friend was diagnosed with Advanced NHL last year.Still doing chemotherapy.Was diagnosised with AIDS April 2000 ,after testing neg every year prior.Before he tested HIV pos he believed that he had NHL after a severe tonsilitis in Dec 99 and that's why he went to the Dr in the first place.But after he tested pos the DR keep telling him his symptons where related to AIDS and not lymphoma.His initial numbers CD4 234 Lymph 8 and VL 4500.He also had a very enlarged spleen,fatigue,chronic cough,weight loss,nightsweats and itchy skin. Even after starting HAART his symptoms worsened but his Vl was undectable within 3 months but CD4 and Lymph idn't improve.Finally in Oct 2000 was diagnosed with Advanced NHL.If he actaully had NHL prior to testing pos would that have effected his initial numbers; his Vl load never got higher than 5000.We just want to make sense of all of this,to understand what's happened to his body.Do people without HIV and have NHL have low CD4's.If you can help us understand we'd be grateful.Thank you

Response from Dr. Dezube

To be honest, I'm not sure I understand all your questions, but here's my best

1) Some of your questions relate to timing of diagnosis- What I can tell you is that the majority of cancer patients will at some point ask whether their cancer could have been diagnosed earlier. What I can tell you is that your friend's story is not unusual. Lymphoma is not all that uncommon so it often presents as something else (e.g. a belly pain, a swollen node, tonsillitis and so on). We get worried about cancer if the particular symptom persists. So it is not unusal for a lymphoma patient to get a different diagnosis to start out with.

2) Can you have a low CD4 count if you have lymphoma without HIV?- Yes. Cancer can cause immunosuppression and as a result can lower CD4 counts, but typically cancer does not lower CD4 counts as much as HIV.

3) I actually do not believe that your friend had lymphoma all the way back in Dec 99, but only got diagnosed in Oct 2000. Lymphoma in HIV tends to be very aggressive. I sort of find it hard to believe that he would be alive with untreated lymphoma for almost a year (12/99-10/00). It would have killed him. Rather I believe hislymphoma is of much more recent onset.

Hope this helps. BD


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