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2nd Set of Labs and I'm Confused
May 21, 2005

Hi There Doctors,

Thanks again for your wonderful resource here.

I am a western guy living in Thailand and myself and my girlfriend have been diagnosed HIV+ for 5 months now. I am still scared, but managing to get on with my life and thinking about planning for a long future - I hope!

I just got my second set of labs back, and I'm confused a little about what they mean.

!st Set: (January) CD4: 767, Viral Load: 111,000 CD4%: 42

2nd Set: (April) CD4: 680, Viral Load: 37,000 CD4%: 38

Now, from what I have read on your site, the average loss of CD4 cells is between 50-100 per YEAR! I seem to have lost 90 in the space of three months!!! This is really terrifying to me.

I know it is good that the viral load has gone down, but is 111,000 to 37,000 a good amount? Should I be happy with this? And what is an "average" viral load to have? 50,000?

is a 4% drop in the CD4% worth getting anxious about?

I am symptom and med-free and would like to stay this way as long as possible. Do you think it really could be 3 or 4 years (or even more) before I need to start medications? And will medications be better and more effective when the time comes for me to start taking them?

My doctor has said to me that the second set of results are fine, and come back for more labs in September and not to even think about meds yet. Do you agree?

Thanks in advance for your answers and thanks again for the website - its great to have a resource like this in Thailand.

Response from Dr. Young

Thanks for your post.

I apologize for the time it has taken for us to answer your question.

It is probably too analytical to make much of changes from only two sets of labs. Indeed for nearly all clinical studies, the "baseline" is an average of two sets-- allowing for the usual amount of variability.

While it is very understanding that you're concerned about your CD4 cells, looking at your CD4 percentages and absolute counts, I really don't see any reason to be terrified. Both sets show CD4 measures that are in the normal range, the CD4% change is within the range that I can expect in patients in your situation.

Same with your viral loads, I'd average the two set of labs for now-- about 75,000. Additional lab work in the future will help get a better sense for where your baseline average is.

Yes, with your current labs, I'd wouldn't expect you to start medications for a number of years still. Further, I agree with you that we will have better medications and a better understanding about how to administer medications in the years to come...

Lastly, I'm in agreement with your Thai doctor-- not to worry.

I hope this helps- enjoy Thailand for me. It is a wonderful place with even more wonderful people and food. BY



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