Drop in CDR Count
Apr 6, 2008
Recently a writer asked about the degree of concern he/she should have regarding a substantial drop in CD4 count over a 3 month period (700 to 420).
The answer was:
"Another important number to follow is the CD4 percent. It is a more stable number over time. If the CD4 percent has not changed, then the change in CD4 count may not be significant. If the CD4 percent has decreased by 3-5% or more, then that decline, along with the viral load increase is significant and treatment may be warranted. The decision to start is not urgent. Another set of numbers will tell you where the trend is going."
My question is: percentage of what? The actual amount dropped (300) relative to the original number (700)? I presume that is what you meant.
Even at that, it doesn't specifically address his question. His decrease is about 40%. Given that you said that a decrease of 3-5% is significant, and may warrant treatment, wouldn't this be extremely alarming?
Response from Dr. Holodniy
It doesn't work that way. You can't look at the absolute count change as a change in the CD4 percent. There can be dramatic changes in absolute CD4 counts and yet the CD4 percents not change by much. The CD4 percent is a reflection of the total lymphocyte count. If the total white blood cell (WBC) count or total lymphocyte count changes significantly, so will the absolute CD4 count, but yet the CD4 percent may not change at all.
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