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New DX, Lab questions

Jul 14, 2013

Dr. Mark,

I was diagnosed two months ago. Prior to this I have always had very good health. I know for a fact it was a very recent infection; 6 months at the very longest, but I believe more like 12 weeks. My numbers at diagnosis were CD4 935, VL 400. The Dr. seemed surprised at these numbers given that I am completely sure the infection was between 12 and 24 weeks. I was put on Atripla, and 28 days later was UD with CD4 at 1075.

I have been on the Internet for hours every day trying to understand my new reality. You seem to be one of the most balanced and educated sources I have found.

In a nutshell - I am confused. Much of what I see from seemingly reputable articles / medical sources is that I should expect an essentially normal life. But then you read posts from various poz people, and they seem to be dealing with terrible issues. Is this mostly because they may be LTS? Or, that they have other health issues because of smoking, drinking, drugs, or just normal other health issues that are not HIV related? I realize every person is different and you do not have a crystal ball - but I am SO CONFUSED about the seemingly contradictory information.

In a nutshell, for an essentially very healthy person, just diagnosed with what I told you above, can you speak from your perspective to my quality and length of life?

The "number" that came back on my last labs which I am not able to understand (and I have not yet had another appointment) is that my "percentage" is 26.5%. I don't know what that means, but I am understanding it is low, which concerns me, since everything else seemed as good as it could be given the circumstances.

Last comment. The only thing I have experienced this month of significance is an increase in joint pain. I have always had this to a small degree, so I would say it has gone from a 1 to a 2.5 on a 1-10 scale.

Thanks so much for reading this...I realize some of my questions are not solely about LABS, but any comment you can give would be so very greatly appreciated.

Response from Dr. Holodniy

First, your CD4 count, prior to, and after starting HIV treatment, is in the normal range. Someone without HIV infection would have a CD4 count between 500-1500. The percent of 26.5% you quote, I believe is your CD4 percent. The normal CD4 percent in someone without HIV infection is 30-50%. It is always good to follow both of those numbers, as the CD4 percent is a more stable number over time, as the CD4 count can fluctuate more. Given that you started treatment early in the course of infection, and your CD4 count is in the normal range (meaning very little immune system damage from HIV infection), and you have no other significant medical problems, then prognosis and quality of life is excellent.

pregnancy and cotrimoxazole
gradual decrease of cd4

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