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worry about cd4
Oct 25, 2006

dear doc. i am 29 year old man recently got detected hiv+ in june 2005 that time my cd4 was 483 and viral load was nearly 19000, than in sept 2006 it shows cd4 486 than in march 2006 cd4 was drop to 450 and now recently in sept 2006 cd4 drop to 348. so my question is what my report shows and what you had study from my reports and little worry about this since i was told by my doctor once i start my medicen than i have to take for the life time i cant stop. belive me i dont want to die soon since i have very little daugter 2 years old and in india its very difficult to servive with hiv+ status for all of us me and my family also have to suffer for my status. [2] i do smoke 3 to 4 ciggrate daily and drink 180ml indian wiskey with water [3] normally i sufer from common cold every now and than. [4] i feel scared and tension when ever i think of this infection and socity. so please do tell me what my reports have to say, do common cold and stress affects cd4 in real and do tell me what should i do to live till at least 60 years that is more 30 years. thanking you and love you.

Response from Dr. Frascino


I'm sorry to hear about your recent HIV-positive diagnosis. It is always a shock to hear such news. A period of adjustment to your new reality is to be expected. Can you live to be 60? Or 80? Or even 100? Well, no one has a crystal ball that can accurately predict the future, but I can tell you, with your recent diagnosis, current CD4 counts and the benefits of the new therapies for treating HIV and its complications, you should have every reason for optimism.

To optimize your chances of dying of old age rather than from HIV, here's what I suggest:

1. Establish care with a competent and compassionate HIV/AIDS specialist physician and work closely with him or her.

2. Learn more about HIV/AIDS and the current treatments available. A good place to begin this process is right here at The Body. Check out the information on the homepage under "Quick Links." There you will find topics that include "Just Diagnosed," "HIV Medications," "HIV Monitoring Tests" and "Inspiring Stories."

3. Stop smoking. Drink alcohol only in moderation.

4. Decrease stress and improve your diet and exercise programs.

To specifically address your concerns:

1. In general those of us who are HIV positive lose 50-75 CD4 cells per year, if we are not on HIV medications. The guidelines currently suggest you begin HAART (highly active antiretroviral therapy) when your CD4 count drops consistently into the 250-350 range. I would repeat your CD4 count before considering beginning treatment to see if your recent 348 was a transient dip or indicative of a consistent downward trend.

2. Intercurrent illness, such as colds and flu, can cause transient drops in CD4 counts. You might consider monitoring your CD4%, as this number is less sensitive to these transient swings than the absolute CD4 number. You can read about CD4% in the archives and in the "HIV Monitoring Tests" section mentioned above.

3. Stress can affect the immune system in several ways. As it turns out, a small amount of stress is probably beneficial to the immune system, but continued levels of high stress can be harmful.

Finally, I'll point out that I've been HIV positive since January 1991 and I plan on dying of old age! I urge you to join me!

Good luck!

Dr. Bob

Am I deluding myself??

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