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Slow CD4% recovery, discordance between CD4 and CD4%

May 25, 2014

Hello Doctor Holodny,

Thank you for your support that is important to so many of us.

I started treatment 11 months ago with CD and VL numbers as follows: 275 (8,5%) VL 380K, and than followed with results every three months: 481 (11%), VL 80, 376 (12,4%), VL 32 and 400 (11,5%), no VL. The last numbers are 442 (13,5%) and we did not get the VL.

Is this a good response? Why is the CD4% recovering so slowly? I understand that having CD absolute count of 442 with only 13,5% is an unusual discordance? Does it mean i have very high absolute number of white blood cells, which can indicate some other health problems? Do you suggest I check out for those other problems? I feel very well, exercise, eat well and have 100% adherence.

Thank you very much!

Response from Dr. Holodniy

The most important fact is that your viral load is undetectable. That indicates a very good response to HIV treatment. That also stabilizes the situation for CD4 count and percent recovery. You are correct that we would expect to see a CD4% of around 20% or more for a CD4 count of 442. Your WBC or total lymphocyte counts may offer some clues but I don't think I would initiate a workup for other problems at this point.

How fast VL reduction after starting meds?
my absolute CD4 count has come down to 314/uL FROM 406 u/L and CD4 has remained to 20-22 to 20 6 months agao.

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