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May 22, 2004

Dear Dr. Holodniy,

My wife is on Evafirenz and Combivir since August 2003. Her latest bloodwork shows a steady decline in wbc, neut and rbc : wbc 3,5 - neut 1.37 (39%) - Lymph 1.78 (51%) - rbc 3.06 - hgb 11.6 - hct 33.9. She is undetectable with cd4 of 499 from baseline 207. I am a little bid worried about the low wbc and neut. Are her levels indicating Neutropenia ? Could the cause be the azt component in the combivir ?

Many thanks for your input.

All the best from Thailand,


Response from Dr. Holodniy

I agree her numbers are on the low side. Neutropenia is usually defined as when the neutrophil count goes below 500. That is when we begin to see an increase bacterial infectious complications. Her count is at 1,370, well above that threshold. It may very well be the AZT causing this. It's also important to review any other meds, herbs that may be contributing to this as well.

normal values

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