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still trying to understand the numbers

Feb 26, 2004

recently submitted question regarding the numbers. The first time : the t4 helper were: 1032 and the vl was 102879 the second time it came back as t4 593 and HIV-1 RNA ultra was 26453 copies/ml I don't understand what this means. How many ml are in the body, and does this now mean that the hiv has increased? Please answer. In other words was the first time also meaning copies /ml ?

Response from Dr. Pierone

T4 helper cells are the same as CD4 cells. The first test was 1032 cells/mm3, second 593 cells/mm3. Both are very good counts and indicate that immune system is in good shape at this point.

Viral load is the same as HIV-RNA quantitative test. First was 102,879 copies/mL and the second was 26,453 copies/mL (so it declined). The middle of these two tests is about 60,000 which is probably an average level for viral load. As more tests are done you will get a better sense of whether your viral load is closer to the lower number (probably so).

These viral load tests are measured in copies of virus per volume of blood (plasma actually blood after red blood cells are removed is plasma). The average human has about 5.5 liters of blood and each liter contains 1000 mL so there are 5,500 mL of blood circulating at any one time. Realize that these HIV viral measurements simply measure the amount of virus that happens to be in the blood at the time of measurement, the virus replicates primarily in deep tissue sites (lymph nodes, spleen, etc) and spills over into the blood stream.

You can see that both of these tests can vary by a large amount. This is very common as well and highlights the importance of looking at the big picture of the trend of these numbers over months to years.

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