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puzzled about cd4 variance results

Dec 14, 2008

for the past 4 years ( post exposure ) my absolute cd4 numbers have always been between 525 to 575, with cd4 % always between 37% to 39% and cd4/cd8 ratios always between 1.5 to 1.7. Never on any meds btw. Important to note the blood tests have always been taken in the morning, and the same lab has performed them year after year. This year however, for the first time I took the test in the afternoon ( still same lab though ) and the results are abs cd4 982, cd4% only slightly different at 40% and cd8 ratio still in relatively the same range at 1.8 I was under the impression the diurnal variation of cd4s from am to pm is 20% , maybe 30% at the most. But nearly 100% ?! 1) Is that a normal delta ? 2) And since the percentage is not too different does that mean that the WBCs are also 100% higher in the afternoon ? And the abs cd8's ? Not sure how to make any sense of this. Something tells me there is no issue at all here, but I'm curious to confirm that or learn if there is something abnormal at play.. Thank you

Response from Dr. Holodniy

I don't think there is an issue here. Yes it does affect other white blood cells. When we speak of diurnal variation we mean that we would be obtaining blood samples in the morning and evening of the same day to determine variation. It is very difficult to interpret your difference, given that the values were obtained so far apart. You are correct, the difference would not usually be 100% and the range is more like 10-50%, but this has not been studied in many people with HIV infection and variation probably relates to age, ethnicity, etc, among other factors.

Elevated ALT/AST from HCV treatment
convert IU/ml to copies/ml

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