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Rapid decline in CBC numbers
Sep 3, 2003

Dr. Young, My CBC came back and, compared to a month ago, showed a huge plunge in Lymphocytes percent (down to 20 from 40 a month ago) and Lymph numbers (down to 1.7 versus 3.2 a month ago). Monocyte numbers are also way down.

I thought Lymphocytes usually declined at a gradient? Have you ever seen such a big drop and, if so, what were the causes?

Also, do such big declines in Lymph numbers in a CBC usually translate into a big decline in CD4 counts and percent?

Is the change within normal fluctuations? I must say that all my prior CBC's have had numbers consistent with the higher Lymph numbers and this is the first time there has been such a big and rapid decline...and it coincides with a worsening of symptoms).

I'd appreciate your perspective and advice.

Many thanks.

Response from Dr. Young

I wouldn't be drawing any conclusions about HIV disease progression on the basis of any single set of tests. Moreover, there is so much variability in CBC differential white blood cell counts (particularly if your having any secondary issues, like even a cold), that I'd advise you to simply contact your doctor about your current symptoms.

Lastly, assuming that you live in a place where getting CD4 counts is possible, then this is the lab parameter that I'd be following (a much more accurate predictor than the CBC). BY

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