|absolute CD4 vs % CD4
Dec 19, 2004
I have been HIV + for nearly 20 years and have not taken antiviral meds. My viral load has remained relatively low (< 10,000 bDNA) and absolute CD4 count always over 350 with wide swings from a low of 350 to about 600. My Doc commented on how he doesn't normally see such wide swings in abosulte CD4 numbers, but mine have always fluctuated that way. My % CD4 was reltively stable in the 23-25% range, however, over the last year it has trended down to a low of 16% 3 months ago. I am due for another lab draw this month. My Doc has suggested considering antiviral treatment if I drop to 15% CD4 or less. I tend to agree with him, but am perplexed as to why, with a low viral load and an inconsistent absolute CD4 count, I am seeing a consistent decline in % CD4. Should we be checking other abosulte lymphocyte numbers besides CD4?? Thanks!
| Response from Dr. Holodniy
If the decline in CD4 percentage is consistent over several lab tests, then it is probably real. Given that trend, I would agree with your doctor, treatment is indicated. Given ongoing viral replication for over 20 years, I think you have just reached that point where your CD4 cells are beginning to lose the battle. Better to intervene now and preserve your immune system.
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