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are there absolutes in HIV cell pathology ?
Dec 6, 2009

Hi Doctor, my treating physician, a leading Bay Area HIV specialist, and a published author in various medical journals on the topic of hiv/aids pathology ( he works closely with an infectious diseases pathology team ) just informed me that my higher than 1:1 cd4/cd8 ratio ( 1.6 ), both of which are incidentally also within normal parameters ( roughly 700/300 abs. ) has never been seen in any of the tens of thousands of hiv + patient lymphocyte subset tests results they have examined for the last two decades...of those patients who have NOT been on any medications, that is... he asserted that without meds any and all hiv + individuals WILL have a reverse cd4/cd8 ratio from the moment of infection until the end of life, and invariably so througout the entire period, so he is puzzled and wants me to undergo battery of tests to determine just how and why this is happening. He also suggested I retake the Elisa/WB again ( eight years into this ?! ) to see if the first tests may have been false. My shocked reply was - Are you kidding me ? I'm going to find out based solely on some CD ratio that I MAY be negative, now eight years into living with the knowledge I am pos ? He maintains this is one of the few person - without the help of meds, there is not even a one case in a million ever recorded with a greater than 1:1 ratio. I am skeptical, but he is relying on empirical info he sees every day. What the heck should I do now ? Get a second opinion or just subject myself to dozens of guinea pig type tests ? Not a problem, just wondering if this indeed unheard of..

Response from Dr. Holodniy

I am not sure what he may be referring to, but there are numerous publications demonstrating that HIV infected, elite controllers or viral controllers have a CD4/CD8 ratio of > 1.0 (and many of those above 1.6).



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