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low white cells low cd4% high viral load and toxo
Oct 25, 2009
My sister in law is back in the hospital with toxoplasmic encephelitis (sp?) with a white count of 2.6 and a cd4% of 15%. Two weeks ago when she was in the hospital her cd4 count was 20 and viral load was 350,000. Her first admit they told us counts and now they tell us cd4 %. We are confused as to what the difference is.What does all of this mean and how concerned should we be. The toxo meds make her vomit and she doesn't seem to be getting any better. She has been on the meds again for two days. She had a week of meds by iv prior to this and was sent home with meds to take. She vomitted for a week before being admitted again. I don't think much of the medicine is making it into her system. She is very weak and has not slept even with ambien and adavan for more than a few minutes at a time for going on 3 days now. Is this a side effect of the toxo meds? She is not on hiv meds because they say they can't give her both. We just want to know if this is normal or if we should be really concerned. She has 3 young children.
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Response from Dr. Holodniy
The CD4 count is how many CD4 cells she has per milliliter of blood. The CD4% is the percent of blood lymphocytes that are actually CD4 cells. Both numbers are important to know and follow. Her CD4 percent is much higher than the CD4 count would suggest. This is a good thing. That indicates that she is likely to recover CD4 cells quickly if she is given HIV meds that her virus is not resistant to and she can tolerate. If someone truly has a CD4 count of 20, the CD4 percent is much lower and is around 5%. Her total white blood cell count is low (2.6) and should be around 5-10. That is likely the result of her toxo infection or the meds to treat it and is what is artificially driving down her CD4 count. I still don't understand why they don't start HIV meds. Both the toxo meds and HIV meds (resulting in control of the HIV infection and big boost in CD4 count) will contribute to her recovery. Her sleep problems could be the result of the infection, the meds, or just being in a hospital, which is not a very good place to get sleep.
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