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CD4, CD4% Changes Over Time
Mar 30, 2008

Dear Dr. Holodniy,

I have been reviewing the information posted on The Body web page about CD4 counts and VL and have a few questions. I hope you can help me because I find contradictory evidence among the questions posted in the forums.

1. What is the typical change in CD4 - CD4% over time for somebody infected with HIV but not undertaking treatment?. I undertand the CD4 count basically depends on the VL. I also understand after VL set up the CD4 and CD4% will decrease over time. Is this right?

2. It is possible/common for the VL to set up at undetectable levels and the CD4 and CD4% to increase over time without treatment?

3. What is the difference between CD4% and CD4/CD8 ratio? I understand CD4% is the percentage of total lymphocites that are CD4 and CD4/CD8 is the proportion of CD4 relative to CD8. Which of these two measures is more reliable in terms of HIV progression?

Thanks in advance for your answers.

Response from Dr. Holodniy

1. The average loss of CD4 count is around 50-70 per year, and the percent loss is around 3% per year. Your are correct in your other assumptions. 2. Viral load can be undetectable without treatment. The CD4 count/percent can increase, but this usually happens after acute infection and less likely later on. 3. You are correct in your definitions. In my opinion, CD4%.



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