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Your expert opinion please on recent labs

Mar 3, 2006


My last set of labs show counts as follows: vl of 2,840 CD4's at 479 with a CD4% being 33%. My labs 4 months prior were vl of 1040 copies, CD4's at 663 with CD4% of 37%. My absolute Lymphocyes were 1815 on my prior lab workup and are now 1432.

I'm a 42 year old female who's been positive for 5 years now and have never been on meds. On my last visit, my Dr. said that it was quite a dramatic drop in my CD4 count and although my CD4 count is still considered good, it may be time to discuss treatment if the count takes another plunge on the next labs.

Another concern I have is the numbers for the MCH which was in the "out of range" column with the number being at 33.9 (last labs it was 32.8). My MCHC had a reading of 36.2 on my recent lab which also shows in the out of range and the prior labs had a number of 35.2.

I have done a little research on the MCHC and the MCH but I don't really understand what this means to me or my health being on the high ranges.

I was a heavy smoker, but just quit a few days ago (wish me luck!), as I get the feeling that the MCH and the MCHC might have something to do with the 2 pack plus cigarettes I was smoking per day.

Could you please tell me if you agree with the Dr. that if my CD4 number plunge again it may be time to begin meds (of course providing that the CD4% drops as well). In your opinion if the numbers drop again would you wait yet another 3 months (August) to check the next set of labs before getting on meds? My next visit will be in May. Also, can you explain to me what the MCH and the MCHC numbers represent, and is it cause for alarm that they too are in the high range?

Response from Dr. Holodniy

I definitely would need to see another set of numbers or two to establish a trend downward in your Cd4 count and percentage before considering treatment. I would not be concerned about those values for MHC or MCHC. They are just outside the normal range. We usually get worried about low values which indicate a loss of hemoglobin in your red blood cells.

Starting meds
CMV and Hiv

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