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lymphocyte subset panel 5
Nov 15, 2006

First i want to thank you for taking the time to read our questions and reply to them. I have an issue. I have been positive for 11 yrs. I have been placed on several treatments but never followed through because of the strong side effects that i was getting. I asked my doctor to put me back on Combivir and Zerit cause that I tolerated very well but he said no because I am resistant to Epivir. He placed me on Truvada, reyataz and Norvir. I've only taken Truvada and Reyataz, but the reyatz made me very nauseas, weak and I couldn't eat. So I stopped taking it. Now I started taking the truvada & tonight I'm going to try the truvada with the Norvir to see if there is any reaction. But I haven't been consistent on taking my pills, though for the last week i have been taking truvada everyday. Now, I work in a doctors off. but no one knows my status there. I haven't seen my doctor in 3 months and I did blood work on myself and ordered a CD3+/CD4+ but since I didn't put the HIV code they didn't do it looking for that. But they did it under lymphocyte subset panel 5 and I looked it up and it says that it is an HIV related test. Can you explain to me the result and how I can get my Tcell count from this. Is there a way that I can order the test to do a cd4 count and viral load without anyone at work knowing that I'm HIV. I know go see my doctor, but I want to know this before I go see him cause he's going to be upset that I haven't gone to see him. I am under alot of stress right now and am scared that my tcells are low, which I know they got to be, cause they were last 286. But like I tell him I don't go by the resistance because when i was in combivir my tcells did go up alot. But he says that if I continued that I would become resistant to everything, so that is why he doesn't want to give it to me. Anyway, the CD3+/CD4+ (helper) 15 Range 30-60 and CD3+/CD4+ (helper) ABS is 300 Range 490-1740 and the Lymphocyte CT is 1973 Range 850-3900. This is what's confusing me that the CDS are abnormal but the lymphocyte is normal. Can you please explain this to me. Everything else is normal except my platelet 117. And the only other problem is abnormal pap. Please help me understand this. Thank you. I will be looking forward to your e-mail. Wanda

Response from Dr. Pierone

Hello, and thanks for posting.

The CD4+ lymphocyte count on the recent test is 300, which is close to the 286 level that you had last time. The normal lymphocyte count is explained by the wide variation of the normal range and the fact that HIV infection is associated with loss of CD4+ lymphocytes, but not all of them.

The larger issue is your relationship with your doctor. Unless you have a relationship where you can tell the truth about your medication side effects, missed appointments, and changes in your regimen, then you have a big problem. So ask yourself if you like your doctor and respect his judgment. Just as importantly, does he listen to you and treat you with care and respect. If the answer to either of these questions is no, then you need to find a new clinician. This does not have to be a doctor; some of the best HIV treaters that I know are nurse practitioners or physician assistants, not MDs or DOs.

Anyway, back to your medications. Simply stated, you need to find a regimen which does not make you sick and controls viral replication. There are many drug choices available now and through a process of trying various combinations of medications you should be able to find a cocktail which is well tolerated and effective. But you need to partner with a knowledgeable clinician who can work with you and guide you though this process. In the meantime, changing therapy on your own may increase the chance of developing greater viral resistance and is not advisable. I hope that this information helps and best of luck to you!

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