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Is my Treatment working?
Oct 27, 2002

Dear Dr. Wohl,

I am HIV positive. Recently after being detected with the virus I started taking some herbal medication. I have now been taking the medicine for around 4 months. My general health has improved tremendously, however my blood tests and CD4 test reports confuse me. I would greatly appreciate it if you could kindly explain the following test reports. I want to know if my condition is improving or going worse. Is the medication I am on working?

Your immediate assistance will be appreciated. Following are two sets of tests for Blood and CD4 that I have undertaken.

Thanking you in anticipation.

BLOOD TEST 02.June.2002 WBC: 8500/c.mm NEUTROPHIL: 47 LYMPHOCYTE: 50 EOSINOPHIL: 3 ESR: 7mm 1 st hour HAEMOGLOBIN 14.6 gm VDRL: Non reactive

CD4 ABSOLUTE & PERCENT COUNTS BY Cytometry 16.Aug.2002 TOTAL LEUKOCYTE COUNT 7000 cells/c.mm LYMPHOCYTE PERCENTAGE 52.20 ABSOLUTE LYMPHOCYTE COUNT 3654 cells/c.mm GRANULOCYTE PERCENT 21.40 ABSOLUTE GRANULOCYTE COUNT 1498 cells/c.mm CD4 PERCENTAGE 15.20 ABSOLUTE CD4 COUNT 555 cells/c.mm

SECOND TEST

BLOOD TEST 02.July.2002 WBC: 6300/c.mm NEUTROPHIL: 45 LYMPHOCYTE: 52 EOSINOPHIL: 3 ESR: 4mm 1st hr HAEMOGLOBIN 11.0 gm VDRL: Non Reactive

CD4 ABSOLUTE & PERCENT COUNTS BY CYTOMETRY 30.Sept.2002 TOTAL LEUKOCYTE COUNT 7500 cells/c.mm LYMPHOCYTE PERCENTAGE 43.10 ABSOLUTE LYMPHOCYTE COUNT 3232 cells/c.mm GRANULOCYTE PERCENT 37.50 ABSOLUTE GRANULOCYTE COUNT 2812 cells/c.mm CD4 PERCENTAGE 12.80 ABSOLUTE CD4 COUNT 414 cells/c.mm

Response from Dr. Wohl

Hi-

I am glad you are feeling better but your laboratory values are a bit concerning. As you point out, your CD4 cell count both by absolute numbers and as a proportion of all your lymphocytes has declined which, if your treatment was working, should not occur. Have you had viral load tests done? Do these indicate a change in the HIV levels in your blood?

Additionally, you have had a decline in your hemoglobin. This is even more concerning to me. I do not know what it is you are taking but I would have my laboratories repeated and have a viral load also obtained. An explanation for your anemia, if confirmed, needs to be found and if none is evident a medical work-up immediately is reqiuired. I would also look closely to make sure your alternative regimen is not a culprit in your anemia.

I am unaware of effective herbal therapies for HIV infection itself. Don't continue with an experiment if it is failing- DW



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