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CD4 jumps and plummets. Why?

May 23, 2009

I was dx w/ HIV at 196 in 4/07, at the time I was also dx'd w/ CNS non-Hodgkin's lymphoma, Stage IVc, but i went through aggressive CHOP chemo w/ mono-clonol antibodies (Rituxan) and came from near-death...then I began, last fall, my Interferon/ribavirin therapy for HepC which I cleared at wk 6 from a sky-high vl (10 million).... I started my HepC therapy w/ a cd4 count of 205, which as expected dropped as the interferon therapy week wore on.... although my percentages were good 18-26%, the cd4 would drop to say 80 in feb, then jump to 135 the next week, itwas down to 80 again 2 wks ago, then it jumped to 128 this week. I always get the blood drawn at the same lab, and I'm totally adherent to meds, don't drink, and do everything the same one week to the next. So why the startling jumps and declines? Are these lab tests really accurate? or dothey just give a relative measure. I freaked when I fell below 100 cd4, until I read about people w/ 5. Can one live long at a chronically depressed cd4 count (like under 50 or 100)? Thank you for your valuable time and for helping all of us.

Response from Dr. Holodniy

Yes, the CD4 count can fluctuate, and as you indicate, will be affected and fluctuate further because of the HCV treatment. It sounds like you have responded to HCV treatment, so you will need to hang in there awhile longer until you complete the HCV treatment, after which I am sure your CD4 counts will increase and stabilize.

big cd4% change?
Relatively High CD4 and Low Viral Load

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