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A colleague from Italy need Your appreciable opinion.
Jun 30, 2002

Dear Doc. Young A colleague from Italy need Your appreciable opinion. Thank You for the last answer and the rapidity, I am really grateful of that.

First question. Who is better a CD4=635; 35; or CD4=781; 27 the first man is without meds the second under meds from 4 years I am a bit confused of the Absolute total CD4 number an percentage of them. It is said that normal percentage is 32-54. Having CD4 =781, and percentage 27 sounds a little strange. I have the last results of my exams the third one, I have CD4+ CD3+ =34; LYMPHOCYTES = 1281; CD4 =436 VL 28000 WBC= 3.98 X 10 LOW the last time were 4.90 and CD4+ =635 =35.VL 45000. My doc tells me that it was a viral infections that lowered my WBC that its true I had a sore throat with small cysts that passed after 2 weeks and that it was only 20-25 days before the blood tests. I am feeling much better than before and during the period before the examination I made some exercise, but after three or more days a had sore throat the same symptoms I told before and was forced to stop exercising but beginning again and again. My MCV changed from 79,6 the first time, to 80,2 the second and 82,5 the last one the RBC always 566-568 milions Now I am doing a lot of exercise and I am quite as before I know I was positive (months ago) I can run for more then 20 min. almost every day cyclete 30 minutes and a lot of other things, really I am feeling better but I still am using xanax 0.75mg twice a day and flurazepam 15mg every night make a lot of dreams and still not fully relaxed. What do You thing dear doc. its exercise that changed my red cells MCV or Hiv is much more faster the ever . Suppressing BONE MARROW and forcing red cells to live longer and being bigger ? I have not the viral load It will be declared Another thing my Lactic Acid was 21 from normal =18; I have mussel self movement is that of stress exercise or of Hiv. I know You have a lot of things to do and suggest if You have a little bit time reserved to me. My best regards dear Doc Young

Response from Dr. Young

Thank you for your questions and sorry for the delay in response.

As for the CD4 counts and percentages; there is considerable variation in the normal ranges; hence, what we expect is based on normalized curves. Yes, it is somewhat atypical to see an absolute count of 780 with a percentage of 27-- this might suggest that this person has a relatively high total T cell or, perhaps WBC count. Indeed, as you point out, acute illness, like a viral infection can dramatically alter your CD4 test results, sometimes unpredictably.

The changes in your MCV (the size of the red blood cells) could suggest improvment in diet (iron in particular); but most accurately needs to be placed in the context of what is going on with your hemoglobin (HgB) or hematocrit (HCT)-- this would tell us if there is a problem in the synthesis or maturation of your red blood cells. I don't think, however that exercise is changing your RBC levels to any significant level. -BY



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