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Jul 9, 2006

Again thanks for your response on my last question. After receiving it i decided to make the extra effort to travel to Bangkok and visit with one of the best known HIV specialists. He agreed with your reply (cd4% very low at 11%) and suggested i get all the blood works done again before starting meds. We even discussed which meds / costs / side effects etc. I went back yesterday all ready to begin meds but again my numbers changed enough for the doc to hold off with the meds. 22/3 cd4 387 12% VL 60500. 25/5 cd4 431 11% VL 39400. New results cd4 694 12.4% VL 51000. The doc wants to test every 2-3 months from now for a better graph to establish a baseline. In your experience is this unusual to have high cd4 numbers with such a low percentage and can you see the numbers improving even more? I might add that i don't know when i was infected but approx 10 months ago i had the swollen lymph nodes, aching joints, nad flue, strange lump on my neck which was removed using a biopsy type needle. The doc here recons that could have been when i was infected.

Thanks again for your time taken to answer people's questions which makes this site one of the most informative places for us infected people to visit.

Response from Dr. Young

Thanks for your post and very nice comments.

It's good to hear back from you.

It's not too uncommon to see patients who have an apparent disconnect between CD4 absolute and percentages-- it would seem that you fit into that category.

In looking at your labs, I can't say that the percentages have really changed too much, though clearly they're in a favorable direction. A closer follow up interval, as you're doing, makes sense to me.

With your CD4% reproducibly below 15, I think that starting PCP prophylaxis with sulfamethoxazole (Bactrim, Septra, Cotrimazole) would be a simple insurance policy to prevent a more serious complication.

So long as you're feeling well (i.e., asymptomatic), I think that following things closely is reasonable.

Stay in touch, let us know what your next labs look like. BY

HIV specialists in Toronto
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