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New Diagnosis- Low CD4 and Low VL
Jul 22, 2012

Hi Doctor,

I am newly diagnosed HIV+. It is estimated that I seroconverted approximately 6 months ago based on when I went through ARS. I have otherwise been healthy and have no other health concerns. My initial set of labs showed a CD4 count 280, CD4% 24%, and VL 6,700. This surprised the ID physician and myself who had suspected my CD4 count to be much higher. Any insight into these labs? I am perplexed how I can have a low VL, but also a low CD4 count at this time... Any thoughts? I am just really concerned and anxious...

Thanks!

Response from Dr. Holodniy

Your CD4 count is low, but lower in proportion to what your CD4% is. Most people with a CD4% of 24% would have a CD4 count of 350-400. Someone with a CD4 count of 280 would generally mean the CD4% is in the 18-20% range. In another example, someone is considered as having AIDS if their CD4 count is < 200 or CD4% is < 14%. All this means is that your CD4 count decreased significantly during acute infection and is likely to recover somewhat, given your currently low viral load. Thus, an additional good number to follow is the CD4% which is usually more stable over time. CD4 counts can vary by time of day, after immunizations, stress, other ongoing infections, among other reasons. I think you have to get a few more points on the line to see what the trend of these numbers will be. If your CD4 count recovers favorably, then HIV treatment can be delayed. On the other hand, if your CD4 count remains low, you will need to consider starting treatment now.



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