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confused by results, time to start meds?
Nov 26, 2006

Hi there... Thanks for all the great work you guys are doing, it's an incredible comfort knowing such dedicated doctors are fighting to keep us alive. I just got my august results from the infection-disease specialist, and they puzzle me. Could you please voice your oppinions? I'm not on meds, haven't had any infections that might cause test biases since i was diagnosed. Seroconversion in sept 05 oct 05, CD4 440, 21%, VL4,4log...... nov 05, CD4 580, 24%, no VL measured.....March 06, CD4 521, 21%, no VL measured.... May 06, CD4 780, 27%, no VL measured.... Aug 06, CD4 477, 19%, VL 4,02 log.

Now i'm a biochemist by profession, i understand my bloodresults, but am wondering why the % varies so much? I understood from literature and reading the forums that these values should be the more stable parameter in measureing the progression of HIV's hijacking tactics depleting - amongst others - my CD4's. I haven't been ill before the blood was taken, so from that point of view i see no cause for the fluctuations in %'s. I was vaccinated with Nef/Tat HIV proteins in a vaccination trial prior to getting infected, could a partially adapted immunology cause large fluctuations? In your experience, when would therapy be initiated in this case (i know you don't have a glass ball...)? Thanks a million! P, Europe

Response from Dr. Pierone

Hello, and thanks for posting.

The short answer is that CD4+ lymphocyte counts exhibit variable degrees of variability depending on poorly characterized, but variable parameters. The CD4+ lymphocyte count percentage tends to fluctuate less than the absolute count, but can still jump around as well. I don't think we really know what a partially adapted immune system does, except perhaps translate into a lower viral load, and your 4 log level (10,000) may be reflective of this.

We don't know when best to start HAART, but a cut-off of 350 CD4+ cells is commonly used. If you decide to use this starting point, it will likely be years from now that you commence therapy.

Best of luck to you!



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