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A Question about Low count of Lymphocytes
Aug 9, 2009

My concern is that my lymphocytes count is low (CD4 count must be low, I think). I've included the data below. My doctor didn't order CD4 count for me. My question is: 1. do you think my blood differential is normal? 2. For a healthy person, is CD4 count the more, the better? is CD4 count an indicator of how well a person's immune system works? I'm worrying about possible HIV infection. The blood work data was from 27 days after the possible exposure. Hope that I can hear from you. Thanks!

WBC: 10.6 (10^3) Neutrophil: 77.8% = 8,247 (absolute) Lymphocytes: 15.2% = 1,611 (absolute)

Response from Dr. Young

Hello and thanks for your post.

The only way to diagnose HIV is by HIV-specific tests- either HIV antibody testing (OraQuick, ELISA or Western blot) or by detecting HIV genetic material-- RNA or DNA, by using PCR tests.

CD4 counts testing alone does not detect the presence of HIV, nor can be used to ask about possible exposure. Using lymphocyte counts to estimate CD4 is sometimes done (though with great caution)- since CD4s represent about 50% of total lymphocytes, you could estimate your CD4 count of 50% of 1600, or 800-- exactly a normal level.

So, in the end, you'll need to get repeat HIV antibody testing about 3 months after your exposure. Until that time (and thereafter), be safe out there.


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