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When is too low?
Jan 17, 2006

Hello, im a 33yo WM diagnosed poz a year ago. Had suspected it since i became terribly ill with cough and fever last winter, wich lasted more than 3 weeks. The problem is that i dont know how long have i been infected for, since my last test(neg) was 8 years ago in 1998, im not on any med yet,And i dont know my numbers, But keep an extremely healthy lifestyle, and keep myself in perfect shape. Although i eventually get some fatigue,mild fever,sleeping disorders, depression, low sex drive/appetite, etc. This winter has been good with my lungs and throat so far, but now i have a stomach infection with diarrhea that wont leave me alone.I have been reading stories about people who have their C4 count as low as single digits and still on their feet!!, wonder how is that possible? going down in such extreme, when a healthy number should be in the late hundreds?..i used to wrongly believe that someone with less than 200 would be already in the hospital,severely ill with plenty of opportunistic infections taking over..etc, a total death sentence...So: Could it be that even if im not that sick or weakened my count is already dangerously low and tomorrow or the next day i can suddenly get a PCP,KS,Cancer, or any other equally dangerous disease? etc my point is: Does the body itself "tell" when is running out of good cells? how low is too low and does a low count always come with symptoms?like weight loss, KS, PCP, etc? For what i understand a count lower that 200 is diagnosed as AIDS, then does it mean that i could already have developed it and not knowing it? When is the immune sytem (in numbers) not able to fight infections by itself anymore? Should i run to the doctor to check up my count/VL immediately? Hope not have made this confusing and repetitive, and thanks for your time.

Response from Dr. Young

Thanks for your thoughtful post.

There is a wide range of clinical symptoms in patients with similar CD4 cell counts-- unfortunately, the body doesn't tell the mind what the CD4 count is. Yes, you're correct that persons with CD4 counts below 200 have an AIDS diagnosis, though not everyone with a CD4 count below 200 has an AIDS complication (like KS or PCP). The risk of having such complications goes up dramatically when counts are lower and this fact is the reason that all treatment guidelines strongly recommend treatment for persons in this situation.

If you were my patient, I'd certainly recommend getting a viral load and CD4 count test (among a lot of others, if you've not have any of the baseline tests)-- you don't need to run, but I'd do it in the near future.

I hope this helps. Write back when you have your results... BY

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