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Viral loads down and cell count down equals what?
Jul 7, 2004

My daughter has just had her second set of lab results since diagnosed as poz last December. First results, in January, were viral load just under 9,000 and cd4 cell count at 980. Almost four months later her viral load is 2,500 but cell count is down to 830. Her doctor, a wonderful, compassionate, overworked clinic doc at an HIV clinic affialiated that is funded almost entirely by the Ryan White Foundation, tells her her condition is about the same and says she is at 36%. She's not recommended any treatment. What is the significance of a drop in cell count of 150 in only four months coupled with a significant drop in viral load? And what does the 36% signify. The doctor does not explain, and my daughter is still so frightened and numbed by it all that she doesn't ask. Can you help?

Response from Dr. Pierone

There is really no significance to the drop in CD4 counts or viral load; this just represents the normal ebb and flow of immune cells and virus in the bloodstream. CD4 counts and viral loads often vary quite a bit and it takes multiple readings to develop a trend. The 36% reading probably is the CD4 percentage of total lymphocytes and is another measure of immune function that can be trended over time. The usual threshold for starting treatment is CD4 count of 350 and viral load > 55,000. Thus, many people with HIV infection can be followed off therapy for years. You daughter has a low viral load and very good CD4 count and this suggests a very favorable long-term prognosis. Good luck!



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