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Please a couple of seconds of your time
Jun 14, 2004

Dear Dr. Thank you for the services that you provide to the people and giving important information to everyone. I have had 8 cbc (as you call in english) for the past 8 years. ranges mininum - maximum WBC 8.6 - 10.2 Lymph total 3.1 -4.2 monos 0 - .7 neutro 5.0 - 5.9 RBC 5.2 -5.9 hemog 17 -18.1 Hematocrit 48-55 VCM 88 -96 PLATS 165 - 192

As the lack of the possibility for a cd4 test, and the stable numbers in the cbc, i would appreciate a couple of answers: 1) It is normal that almost everything is the high levels? 2) If infection is suspected 9 years ago, does these numbers look good or just not say anything? 3) The hard one, knowing that is impossible to guess, but at least an idea what would it be more or less the minimum cd4 numbers that you would estimate with the results above?? (knowing that it would be a rough and inexact number, and without compromising your opinion) 4)Is the time for meds still away? Thank you, really thank you Nando, Paraguay

Response from Dr. Pierone

Hello Nando, there are studies that speak to your question. The short answer is that you are likely in good shape with regard to CD4 count even though you can't get them measured yet.

A study at CROI last year at this link examined the relationship between the results of a complete CBC and CD4 counts. They showed that a lymphocyte count below 1070 predicted a CD4 count below 200. For those with a lymphocyte count between 1070 and 1500 (1.07 and 1.5 on your scale) the hemoglobin level aided in prediction. For this group, a hemoglobin level below 13 suggested that the CD4 count would be less than 200. Finally, anyone (this is rare though) with a platelet count below 100,000 was at high risk of having a CD4 count below 200. Since this is a predictive model it is not as accurate as actually measuring the CD4 count, but performed well and was able to identify 88% of persons with CD4 count below 200.

Since your numbers are well above these thresholds and you have had infection for many years this suggests that your infection with HIV is progressing slowly and that it is not time for medications yet. Best of luck!



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