Elevated red blood cell count / polycythemia

Mar 24, 2007

Since June of 2006 my lab work shows my red blood cell count going higher and higher. I switched to a new med combo in June of 2006. For the past 6 years I was on Combivir and Kaletra with excellent results. My new combo is Truvada/Reyataz/Norvir. My doc says that the AZT in the old combo could have been masking the elevated red blood cells for some time and now they are rising due to stopping the AZT. Ive done a pulmonary function test which was 100% normal. I did a sleep study just last night to see if apnea is the cause of the polycythemia. Of course I dont have the results yet but I do know that my apnea was not severe enough for them to start me using a mask during the study last night. Is there anything in the new med combo that could be causing it? Any ideas or feedback would be greatly appreciated. My history in a nutshell: HIV+ since 1986, lowest CD4 count = 6 in July 1999 with Vload >750,000. Grand mal seizure in 1987 and 1989 before finding successful med combo in July 2000. Since then steady improvement with VL undetectable since July 2000, CD4 count fluctuates 250-350, current CD%=18, and overall very good health. Thanks!

Response from Dr. Holodniy

Your doctor may be correct. However you don't indicate what your red and white cell values were and are currently to determine how significant the increase was and if this is a problem or not. Many things can cause polycythemia (drugs, altitude, genetic disorders, cancers, etc). If the increase in red and white blood cell number is significant a good evaluation by a hematologist may be in order.