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conflicting lab results?
Aug 25, 2007

Diagnosed June '07 after yearly negative tests. Initial lab work was cd4 at 298, 20%, and v/l at 262,000. We agreed to wait 3 months for 2nd baseline data since no OIs, and general health is great.

Results back today and I'm somewhat upbeat - t cells up to 378, but % dropped to 17!! v/l in almost half, down to 145,000.

Game plan then was Atripla and dr agreed it made sense for one more data point.

So why would I get great tcell increase but a 3% drop? I thought 3% from some of the postings was meaningful and can't put that in context with the good news of an increase in tcells?!!

Regardless, I will start Atripla after meeting with him next week unless he's changed his mind pending these results. At 50, and "youthful immune system" not on my side, I'd rather attack it head on since the 350 tcell # I learned is artificial and more evidence emerging that earlier treatment is yielding great results.

He's awesome as is his nurse so I am truly blessed with great compassionate care...and family members that are a distance keep checking in to see if I'm ok, need to vent, whatever. I truly wished all those in my situation have the same emotional/psychological support.

Thanks in advance if I get chosen to be answered...you folks are doing a GREAT service to get at facts, not fiction/lies, mistruths.

Response from Dr. Young

Thanks for your post.

When there is this sort of question in CD4 assays, I'll defer to the CD4 percentage. Hence, looking at your labs, they show a decliing trend-- one that approaches the AIDS-defining percentage of 15.

Your absolute CD4s really aren't in conflict either- rather, I think that there's a tendency to overthink the precision of the tests. Indeed, for all clinical trials, two baseline CD4 tests are used to establish a baseline value rather than relying on a single test. Hence, 298 and 378 could readily be averaged to about 340-350.

Overall, I'd find that whether you look at percentage or absolute, your lab tests show CD4 values that are within my thresholds for considering treatment. Add to this your high viral load and less than "youthful" immune system, and I'd conclude that medications might be a good idea.

I hope this helps. Write us back and let our readers know how things turn out for you.

Best of health. BY



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