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Are high MCV and MCH okay?
Oct 15, 2005

Dr. Mark, I hope you can help me out. I'm living in Mexico City and getting treatment and, as there is the potential for miscommunication, I'd like to pose a question to you so I have a good understanding in English before heading off to see my Doctor. I've been HIV+ for less than two years and on treatment for 14 months (Combivir and Viramune). My doctor sent me for routine bloodwork to keep an eye out for anemia. My question is this: My white blood cells and red blood cells are both out of range (on the low side, WBC 3.8, RBC 3.73) hemoglobin normal at 16.2 g/dL, hematocrit normal at 47%, MCV high at 126 fl and MCH high at 43.4 pg, all other numbers are in the normal range. I'm in great health, exercise regularly and take vitamin supplements. The lab results point out the possibility of macrocytes which, from what I can see, point towards zidovudine adherence (a good thing). In your opinion, do the high MCV and MCH point towards anemia and, if they do, can I stay on my current regimen if I feel fine? Thanks so much for your help. Translating in Mexico City

Response from Dr. Holodniy

Although your red blood cells are a little low you do not have anemia based on your normal hemoglobin level. YOu are correct, the high MCV and MCH are from AZT in the combivir. Nothing to worry about and you can stay on the regimen.



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