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Is my immune system healthy or not?...confused
Jun 1, 2010

Back ground. Diagnosed May 27 2008... CD4 88, CD4 % 15.4 , CD4/CD8 ratio .23 to 1, CD8 ABS VL 98,538.

Fast Forward 2 years. February 2010... CD4 251, CD4% 34.8, CD4/CD8 ratio 1.76 to 1, CD8 ABS 142, VL Not DET

May 18 2010...CD4 239, CD4% 33.2, CD4/CD8 ratio 2.13 to 1, CD8 ABS 112, Vl Not Det.

Everything I read says that a better indicator of immune system health is cd4% because cd4 abs can fluctuate. I also have read that a cd4% above 27% is considered good. But the confusing thing for me is that they say a cd4 of 28% should equal a cd4 abs of 450-500.

My question

I have ratios cd4% 33.2, cd4/cd8 ratio 2.13 to 1 Both well into the normal range.

My Absolute numbers are weak. cd4 239, cd8 112 Both really low.

Is my immune system good in the normal range or is it low because of the absolute values? Isn't it odd to have such low absolutes and normal ratios?

Thank you!

Response from Dr. McGowan

The percentages and ratios represent that you have been able to retsore the balance in your immune system that had been disrupted by the virus. The low absolute values for both CD4 and CD8 reflect an overall low level of T cells in your blood. This may mean that your bone marrow (which makes the white blood cells for the body) isn't producing cells at a high level or that the cells are not circulating in the blood but may be out in the tissues and organs. Many times if treatment is started when the CD4 count is low (as in your case), the numbers may level off at a lower range. Most people will remain healthy at this level, especially since your count is above 200. The numbers may continue to slowly increase over time if the bone marrow recovers more so keep on your meds.

Best, Joe

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