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How am I doing? I am not so hopeful, followup.

Sep 28, 2003

Following up to my posting of Sep 22, 2003: You said I did not indicate WBC or total lymphocyte count. Those things that were L (low) or H (high)when compared to reference range in my 8/14/2003 blood chemistries were: WBC 3.0 L; Neutrophilis 77 H; Lymphocytes 14 L; Absolute Lymphocyte .4 L; CD3 Pan T Cell 79 H; CD4-Helper T 8 L; CD8 Suppress T 69 H; CD4:CD8 Ratio .10 L; Abs Lymphocyte Flow 420 L; Absolute CD3 332 L; Absolute CD4 34 L; Absolute CD8 291 (within range); Sodium SerPl QN 134 L; Carbon Dioxide SerPl QN 30 H; Cholesterol SerPl QN 259 H; Triglyceride SerPl QN 346 H; LDL Calculated QN 140 H. HIV RNA Ultra Sensitive <50; HIV RNA Ultra f Not Detected. All other chemistries were within range. With my history, does anything jump off the page either in my treatment regimen or otherwise obvious that I should discuss with my HIV/Aids doctor? I believe I have an excellent ID team, but they have been unable to figure out the see-say effect of my CD4 count and the CD4 percentage. Dr. Holodniy, thank you again. I am most grateful for your encouragement and I will "hang in there and go forward" armed with as much information as I can possibly gather.

Response from Dr. Holodniy

Your CD4 count is so low, despite a great treatment response, because all of your white blood cell count is low. Starting with your WBC and proceeding with your total lymphocyte count, these numbers are significantly low and account for why your CD4 count is low. This is probably related to bone marrow suppression of white blood cell production and could be the result of HIV infection itself, other infections, or medications you are taking. When people start HIV meds with very advanced AIDS, they have lost significant reserve and reversal is sometimes slow in coming if at all. If your doctors have ruled out all the other causes for bone marrow suppression, then at this point time is the only thing we have to determine whether you will have significant recovery. Keep the faith.

3 sets of labs in 6 weeks
Viral Load, CD4 Count and the percentage of the two

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