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Pre infection/post infection Lymph numbers: usual course?

Apr 11, 2004

My pre infection Lymph percent and total were much lower (in the low twenties for percent and normal, but just under 2,000 for Lymph total) - now, 28 months after infection, my Lymph percent ranges from the high 30's to most recently 50 percent and the Lymph Total from 2,100 to most recently 3,500 (was 2,100 a couple of months ago).

I have been infected for 28 months...shouldn't Lymph percentages and totals usually be lower after infection and trend lower and lower versus being higher virtually every time measured in 28 months post infection...even more than double now than in the year before infection?

Or is a high Lymphocyte percent and total the normal response to HIV or other serious infection..where for a few years or more, the Lymph percents and totals will be much higher than pre infection...and then, when the immune system has been tired, the levels slip well below pre-infection levels?

I am confused and would appreciate your explaining the usualcourse. I would be glad for the much higher Lymph numbers, but for the possibility that they may present a lot more CD4 and other cells to be killed by the virus and but for the possibility that they are a sign of a virulent virus (which might explain the highly activated immune response?). Is mine the usual course for HIV disease progression...or are high Lymph numbers/percents 28 months after infection a good sign? CD4's have been 600 in the few months after infection and currently range from 950 to 1,200,depending on day and time drawn. CD4 percent went down to 32 last year, but is now 42 percent.

Many thanks. Best Regards.

Response from Dr. Holodniy

The devil is in the details of your total lymphocyte count. I suspect given the CD4 counts you have now, that what you are seeing is an excellent immune response to HIV infection. What usually happens is you have an increase to some degree in CD8 count (the major response to HIV infection) followed by a decline in CD4 count over time (the major cell infected and killed by HIV). In people who become infected and whose viral load is very low or undetectable, they usually have doubled their CD8 count, which becomes the major contributor to your total lymphocyte count and why that number is so elevated now.

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