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Low CD4 from day one
Apr 1, 2005

Hi there, I was diagnosed with HIV just two months ago. My VL is about 8000 and my CD4 is averaging at only 300. My doctor says this is no need for concern, but I see people who are at 600 and 1000 and 300 seems below average. I'm worried that I'm a rapid progressor. Is it normal for patients to have such a low CD4 count from day one? I know there is nothing I can do to stop the virus, but will staying healthy will prevent my CD4 from going down? Any advice?

Thanks very much

Response from Dr. Young

Thanks for your post.

A couple of thoughts seem relevant here. First off, the lower limit of normal in most clinical laboratories is 350. That means that many uninfected, healthy persons can have values at this level.

Further, after HIV infection, even early on, there is a small decrease in CD4s.

Lastly, some people have a relatively low absolute CD4 count with higher CD4 percentages-- you could fall into this category.

All said, it's understandable that you'd have concern that your CD4 count is less than the lower limit of normal only months after diagnosis. It's important to distinguish between time of diagnosis and time of infection-- it could be that you've bee infected for a longer period of time. If so, this could readily explain your CD4 count. You have a relatively low viral load and this suggests that you won't have rapid progression.

Clearly, at this and any other time, focus on staying healthy (avoidance of secondary health problems, like tobacco-related disease; attention to diet and exercise) will help your overall health and disease risk.

Hope this helps, BY



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