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Feeling Sick and Being Well or Feeling Well and Getting Sick
Feb 21, 2005

Can how one feels predict the results of the next set of labs?

It is common to find people who feel well and then turn out to have very low CD4 counts.

This is true both on and off therapy.

It would be useful to see what differences might be found between HIV+ people with a given cell count/viral load who feel well,HIV+ people with a given cell count/viral load who feel ill, and for HIV+ patients with higher CD4 counts HIV- people.

This might be useful warning system for CLINICAL progression that could fine-tune the surrogate markers used today.

Response from Dr. Frascino

Hello,

Unfortunately, with HIV disease how one feels does not necessarily predict viral load or CD4 cell counts. This is true both on and off therapy.

Yes, there are "clinical" signs of potential disease progression (immune deterioration), such as the development of an opportunistic infection. However, just feeling good or bad does not accurately predict either viral activity (viral load) or immune integrity (CD4 cell count).

For now, our surrogate laboratory markers remain preeminent as the most accurate assessment of HIV disease activity and prognosis.

Hope that helps clarify things for you.

Dr. Bob


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