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CD4 up and down-time for treatment
Dec 27, 2004

My 18 y/o daughter was diagnosed w/ HIV in May of this year. In June, her CD4 was 502, viral load 42,000. In August, her CD4 was 549, viral load 56,679. In October, her CD4 dropped to 292 and her viral load dropped also. A different test was used, so I was unable to compare the numbers. Her Dr wanted to start her on treatment and recommended a clinical trial that just started. We did her labs again on 11/19 and her CD4 went back up to 515 and once again, the viral load test was different again due to the test used for the clinical trial, I do know it was 15,300. I am wondering now that her CD4 went back up, should we start treatment or not. I do not really want to lose the opportunity of trying out the new drug, but we did not want to start treatment until we really felt it was neccesary. I would appreciate any input you can offer.

Response from Dr. Pierone

Majority rules, so your daughter's CD4 count is really in the 500 range. The reading of 292 was an outlier. With counts in this range it is not necessary to commence treatment. Along with the opportunity to try a new drug, comes the risks of trying a new drug. Just because an antiretroviral is new does not mean that it is going to be proven superior to standard therapy and the decision to enter a clinical trial should be carefully considered. I am a fervent believer in the crucial role that research plays in advancing AIDS treatment, and ask my own patients to get involved studies that I am conducting. But the reasons and details of the study should be carefully reviewed before getting involved. Hope this helps.

up and down labs

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