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Question about WBC numbers
Jan 18, 2004

I'm curious about why my WBC count has dropped throughout last year, from 4800 (4/03)to 4200(7/03) and last count to 4000(10/03). Is there a significance to the drop? Is it detrimental to have as low as a 4000 WBC? My lymphocytes percentage and absolute count went from 30/1440 (4/03) to 32/1344 (7/03) to 33/1320 (10/03). During this time my vl remained undectable and CD4 went from 619/43 to 645/48 to 594/45. Any significance to these numbers?

Could you elaborate on whether different people with or without HIV have different CD4 maximum numbers? Is the goal always to get the CD4s over 1000? Or is it possible that some healthy people wouldn't have that high of CD4s even if they didn't contract HIV? Is CD4 a good gauge for overall health? Should people on HAART expect their CD4s to keep going up and up or is it fine to average between 600 to 700?

Response from Dr. Holodniy

A normal range of CD4 count is 500-1500 (30-50%)in people without HIV infection. Depending on what your CD4 count is when you are infected, and/or when you start HAART helps determine what your set point and final CD4 count elevation will be. Since we don't know the pre-infection baseline CD4 count in most people, it is hard to know whether they get back to that number after HAART. It is not expected, nor necessary, to keep increasing one's CD4 count after it gets to 500 or 30%. In looking at your numbers, I would not be concerned about your WBC, lymphocyte, or CD4 counts, which are pretty much within acceptable variation ranges.



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