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Massive drop in Lymphs in just one month
Aug 15, 2004

My Lymph percentage went down in one month from 49% to 19% (the former being the highest for normal and the latter being 6 below normal). My CD4 percent this month is 47%, so based on the WBC count,Lymph percent and assuming the same (or close) CD4 percentage a month ago when that CBC was done (no T cell subset at that time), my CD4's would have been 1,500 and - based on the actual T cell subset done last week- were 700 a month later. The WBC's went from 7.7 last month to 8.5 this month. Sed Rate was normal at 5.

I felt very ill last week, with much nausea that did not respond to drugs, feverish feelings, shortness of breath etc. and it coincided with that huge drop in Lymph percentage to well below normal and what seems to have been a massive fluctuation in CD4's - can IV itself cause such a huge drop in Lymphs (the Lymph number also went down from 3.6 a month ago to 1.5 this month).

I would appreciate your explanation - could basic 'flu have caused that drop in Lymphs from 49 to 19%?...it worries me greatly that there can be such a sudden and large drop in Lymphs. Have you seen this before and could it be due to a virulent virus? These types of fluctuations have happened before and I have even dropped 500 CD4 cells in a few months and then recovered 300 by a few months later. My CD4 percent has also dropped from the high 40's to 32 percent in a few months and recovered later.What is happening?(the nadir for my CD4's was 490...the highest was 1,600).

Is there no stability/predictability to Lymphs...no ability to rely on good numbers forone month at least assuring some months of a robust immune system?

Many thanks.

Response from Dr. Pierone

Based on what you have described it sounds like you had some sort of viral infection that led to the rapid drop in the lymphocyte count. No telling what it was, but almost certainly the lymphocyte count will be back to the normal range for you within 2 or 3 months. Aside from this, some people demonstrate considerable variability in CD4 counts/percentages and viral load readings over time. Why some persons with HIV infection show this pattern and others have very little fluctuation is not really known.



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