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CD4 count down rapidly??
Jan 21, 2004

my wife is HIV positive & i have recently tested negative she first tested positive in May last year when her CD4 levels where just over 1000, then again in july at just under 1100. but we have gone back this time and just recieved the results of cd4 750?? is it normal to drop so quickly?? we moved home in sept & married over xmas so a lot on our minds but seems to have dropped so much. the doctor has said dont worry because the cd4 is still at 28?? can you answer??

Response from Dr. Frascino

Hello,

First off, congratulations on your recent wedding! Next, is your wife seeing an HIV specialist? If not, she should be. The specialist will (or at least should) be able to address all your concerns about lab results and other issues treatment options, magnetic couple concerns, and just about anything else that might come up.

Regarding your specific concern related to CD4 counts. CD4 cells are also known as "helper" T cells "helper," because they help mobilize an immune defense, and "T" for thymus, the organ that produces them. The normal range of CD4 cells is fairly broad from 500-1600, depending on which laboratory is running the test. Your wife's values of 750-1100 are all well within the normal range. CD4 counts can vary up or down in this normal range from day to day and even within the same day due to many normal factors. This type of variability is not concerning. The "28" number referred to by your doctor is the percentage of CD4 cells. This is another way of monitoring CD4 counts, and is subject to much less variability than the absolute number. The usual percentage range is 30-60, again depending on the laboratory used.

So what should your wife do? First, get established with an HIV/AIDS specialist. Next, monitor her CD4 counts and viral load tests every three-six months. If her counts fall consistently below 500, she should be tested every three months routinely. Don't be concerned about a single sudden CD4 drop or spike. These often turn out to be transient flukes. The important thing here is to monitor for trends. A downward trend is the real red flag. Most treatment guidelines suggest treatment be started when CD4 counts are consistently in the 250-350 range and/or viral load is above 50,000.

Hope that helps. Good luck.

Dr. Bob


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