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up and down labs
Dec 27, 2004

thank you for taking my question. i learned of my status in april 2003 first counts were 450cd4 and 32000vl. three months later they read 680cd4 and 1760vl. in july 2004 the count was at 480cd4 and 65000vl. last dr. visit had me at 440cd4 and 2600vl. i am not on any medication so can i ask you what your opinion is of the up and down counts?

Response from Dr. Pierone

The CD4 counts are good, in the 450 to 500 range mostly. It is common to get occasional CD4 counts that are way off compared to the other readings. It should be noted that CD4 cells measured in the blood account for less than 1% of the CD4 cells in the body. They use the bloodstream like cars use a highway to get from one locale to another. Sometimes they get measured at rush hour, other times during a lull period.

The viral load fluctuations are a different matter. Quite striking differences in viral load of 10 fold (or 1 log) are not uncommon. At least a partial explanation for these spikes in viral load readings has to do with immune responses. A simple vaccination (or infection for that matter) may lead to more vigorous viral replication. This is probably related to lymphocytes that are latently infected with HIV which become activated in response to the vaccination (or infection). As these lymphocytes are awakened from their dormant state, so is the HIV that they carry, and this leads to another cycle of viral proliferation that is reflected in higher viral load levels.



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