Fistly I apologise for choosing you to ask these questions, but you drew the short straw! Actually I hoped you might be able to answer them. I have recently been diagnosed with HIV related Lyphoma which is displaying all the weird HIV none sensical things i.e. its not in my lymph nodes, bone marrow or anywhere apart from a 4cm lesion on my liver. I am 41 male and healthy except HIV and now this. Anyway after seeing a top HIV oncologist I am currently on CHOP every 3 weeks times 6. I have a few questions I hope you can help me with. My CD4 was 390 - 38% VL <40 CRP 120. I had also been having temp spikes for 4 weeks.My only sympton. After my first CHOP these "spikes" stopped and have nt returned, had my second CHOP and again no spikes. Now to my question - How long does the steriod in CHOP stay in the system - I take 75mg for 4 days - could this be masking the temp spike for the entire 21 day period or is it a sign the CHOP may be working. Hope that makes sense. Secondly my CD4 dropped to 118 but % remained stable - is this normal and if so how long after finishing CHOP will the actual get back to normal again. And finally my CRP dropped to 19 after my initial CHOP has reduced a little further - again will this be due to the 4 days of steriod use or again is it possible good sign of treatment working. Sorry - this really is finally are there any other markers I should be checking for. Thanks in anticipation. BTW finding CHOP dare I say it very easy is not causing any major problems. Lucky I guess. Thanks again

Unlikely that steroids taken for only four days would mask a temp spike for 3 weeks. Yes, in many HIV infected patients receiving treatment for lymphoma, we see a reduction in CD4 count, in addition to a reduction in other white blood cells. C-reactive protein (CRP) is a very nonspecific marker of inflammation and and increased level could be the result of ongoing infections or malignancy. A reduction as you have described could be the result of steroids alone and/or the chemotherapy. But steroids are part of CHOP, so hard to tease out. There are not necessarily any other good markers to follow and your case present challenges as to where any residual lymphoma may be lurking. Some form of scan, paying particular attention to the liver is likely the best way to follow your course by looking for resolution or reduction in size of the liver mass.