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Your opinion on my numbers please
Feb 11, 2007

Hi Doctor Young, First of all ,Thank You for the inspiration and the honesty that helped me through those first few weeks after my diagnosis.

I would just like your opinion on my diagnosis/prognosis.Diagnosed onOct,06 cd4 237-22%VL37K StartedAtripla 5 days later.Follow up test mid November(Here's the part that doesn't make sense)Late November results(CD4526, VL 720, still 22%My doc(who's excellent in my opinion) stated that my first CD4 may have been an "artificial low". Does this mean that I really didn't need to start meds yet? Does my percentage correspondmore to the 526 or the 237? One last question... I'm a 44 yr old male,recently had an anal wart removed along with part of a fissure. Doc said results came back as dysplasia..He said that it was just one step away from normal Not sure what he meant by that. Reading alot(perhaps obsessing)about HPV now...In what you and your colleagues have seen, is it still a relatively low percentage of HIV+ gay men who go on to develop anal cancer? I'm very confused.

Response from Dr. Young

Thank you for your post.

I would have been in agreement to start medications, though I prefer to get a second set of labs and HIV resistance tests before selecting medications.

On average a CD4% of 15 is equivalent to an absolute count of 200, and a percentage of 22 correlates to a CD4 abolute count of about 300. If you take your two labs (not even accounting for any increase in CD4 due to meds), you get an average of 237+526/2= 380; close enough to current treatment guidelines that medications are warranted.

Anal dysplasia is not uncommon among our patients (when we can get the test performed)- there aren't good studies to indicate what percentage will progress on to frank cancer (probably a low number, but medically significant). This means that you'll need to get periodic health checks, with attention drawn to your anorectal health.

Hope this helps, BY



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