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Feeling Well Feeling Ill and CD4 Counts/Viral Load
Feb 22, 2005

Dr Pierone

Could you cite any studies that compare subjective reports of well-being with CD4 count, viral load and other markers?

It is common to find people who feel well and then turn out to have very low CD4 counts.

This is true both on and off therapy.

It would be useful to see what biological differences might be found between HIV+ people with a given cell count/viral load who feel well,HIV+ people with a given cell count/viral load who feel ill, and for HIV+ patients with higher CD4 counts HIV- people.

This might be useful warning system for CLINICAL progression that could fine-tune the surrogate markers used today.

Response from Dr. Pierone

There have been a wide variety of studies done on quality of life measures in HIV-infected patients. In general, the lower the CD4 count, the higher the viral load, the poorer the quality of life. But you are right that these larger trends do not reflect the many individuals who don't fit into this pattern.

The idea of identifying markers or characteristics that differentiate "well" patients from "unwell" patients is a good one, and is certainly worthy of study. It would be a formidable task, since one could look at so many potential variables (blood tests, genetic factors, environmental issues, psychological traits, etc) that could impact health status perception and quality of life.

If specific linkages could be identified, beyond warning, they could also be addressed therapeutically in an attempt to improve quality of life in "unwell" patients.

Thanks for posting.



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