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Ask the Experts about Opportunistic Infections

 

numbers 101-questions re: ks/chemo effects
Aug 31, 2000

I recently started meds tcell count 250 to 400 in 60days (may to july) -- vload undetectable; also have hep c and ks. started chemo -- two treatments in last four weeks and 50 % disappearance. feel good about that. now on this last treatment they informed me that my counts were borderline whereby the platelets were low and they were going to hold off chemo. we decided to be aggressive and go with second treatment anyway. I am rather rather confused with the count statistics/relationships. could you please explain? I assume that when I get my tcell count in september it will be low due to the fact of what they told me at chemo. do the platelet counts mimic that of your tcell? and what numbers do they look for when administering chemo vs the regular t-cell/viral load numbers? there are a lot numbers out there? again thanks for your help, your service has been extremely informative and uplifting in a sea of confusion.

Response from Dr. Feinberg

Chemotherapy can affect any or all of the 3 components of a blood count: red cells, white cells (which includes T cells) and platelets. Platelet counts do not necessarily track along with red or white blood cell counts. While the total number of white cells (including T lymphocytes) can be reduced by chemotherapy, the percent of T helper cells (which is what the machine actually measures) should not decrease significantly if you are continuing to take your HIV meds, and it might actually increase. Over time, the best way to assess how your T cells are doing is to look at the trend of the T cell percents, not the total number of T cells which is derived from multiplying the % of T cells by the number of lymphocytes (a type of white blood cell). In order to safely give chemotherapy, the doctor will assess the 3 main components -- red cells, white cells, platelets -- and not the T cell number or percent.



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