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An opinion, please

Sep 6, 2004

When I was first diagnosed with HIV (October of 1994) my CD4 count was at 760. No VL count was taken and I was advised to hold off therapy. I waited four years, by which time I had developed an OI (Candidiasis), my CD4 had dropped to 156 and my VL was a whopping 750,000. Within 6 months or so, my VL had become undetectable (by ultra-sensitive standards) and my CD4 began a steady climb upwards. Thanks to good adherence, and all the other general stuff (diet, exercise, no drugs or booze, good attitude, etc.) I had finally reached a CD4 level of 681 last year, at which time my doctor cautioned me that, while further increases were probable, they would be gradual. (My previous tests had recorded a CD4 of 618). Well, I had my most recent tests done this July, and while my VL remains under 50, my CD4 has jumped to a staggering 1048. Comparing the rest of the data between last year's tests and this year's, The CD3s were at 2080 (in 2003) and in 2004 are at 3371. Percentage of CD4/CD3 was 33% in 2003, 23% in 2004. CD8 in 2003 was 1399; in 2004, 2113. Percentage of CD8 in 2003, 67%. In 2004, 46%. The quotient of CD4-CD8 in 2003 was 0.49 and in 2004, 0.50. There is also some data that appears on my 2004 results that isn't on my previous tests: CD45 is listed as being 4590, and the percentage of CD8 is 46%. My doctor feels that perhaps the high CD4 reading might be in error, and he recommends another trip to the lab soon; I would prefer to wait a few more months. Any thoughts that you have would be appreciated.

Response from Dr. Holodniy

You have had dramatic success and speaks to the potency of current HIV treatment regimens. I tend to agree with your doctor, it seems a bit out of the normal range for a CD4 count increase. Since it is an upward deflection (not a decrease) or error and your viral load is undetectable, I am not sure there is a need to retest right away.

Why wait to start meds?
Did I recently seroconvert?

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