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Mar 7, 2010

Since on meds starting two years ago (truvada,Novir,Reyataz) with no doses missed, my CD4% has pretty much remained around 30% (averaged). ND since starting meds. Over the last year and a half, my CD4 count has ranged around 630. The last two labs, my CD4% have been 29.2 and 28% respectively.

I have read that the way to calculate CD4% is to "obtain a total white blood count, then the total number of lymphocytes is counted on the same machine. The percentage of CD4 and CD8 cells are obtained on a separate machine. The absolute number of CD4 cells is obtained by calculating this number from the absolute number of total lymphocytes times the CD4%."

What should my CD4% be with a CD4 count of 647 (last lab count). My latest WBC was 6.3 (thousand/u),LYM AB 1648 (cells/ul). CD8q was 54%, CD8 absolute was 1249 (cells/ul) and CD4/CD8 ratioq was 0.52. Should I be concerned that my CD4% has not really climbed in two years? Thank you.

Response from Dr. Holodniy

You are essentially correct or your math. However, lymphocyte counts are made up of t cells (CD4 and CD8) and b cells (the cells that make antibodies). So there is a third component here that needs to be factored in, which is why you can't get an the answer completely. Now to your current numbers. You are in very good shape. In almost all cases, we don't know what the CD4 count and percent was prior to infection. The normal range is usually between 500-1500 and 30-50%. You could very well be at the place you would naturally be without infection, and therefore not see any further rise.

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