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10% NHL risk? Wow.
Feb 3, 2011

Hi Dr McGowan,

Here: ( it says 10% of HIVers will eventually develop this fatal condition. Is this true? It seems terribly high. I was infected in April 2008 and on meds in August 2008 and undetectable a few weeks after, and have been since. That's the good news, unfortunately, my CD4 count has been around 200 ever since. Does this constantly low CD4 count (percentage increased from 14 to 30) increase the risk of NHL or other malignancies, or does the fact the virus was suppressed in the early stages of my infection (after 4 months) have a protective effect that extends beyond the damaging effect of having a low CD4 count? For the record, there is evidence of pre-existing neutropenia from blood tests (for an unrelated skin condition) giving a HIV negative white blood count of 2.7 and total lymphocytes of 0.46. I don't know what CD4 count this equates to, but it might explain my low numbers? Is this right? Should I be worried anyway, especially given the link posted?

Thanks again for your incredible time. M.

Response from Dr. McGowan

Dear M.

The numbers for NHL of course reflect a couple of factors: it may take many years for NHL to develop so the effects of HIV treatment advances may lag behind in the rates of new diagnoses; also certain people are at higher risk: co-infection with Epstein-Barr virus (which is very common), having prolonged, unchecked HIV viral load for many years (not in your case), having persistantly low CD4 count (again maybe not you...although your counts are low it seems HIV isn't the main cause of it...your CD4 % is approaching normal so the 200-300 range may be your "normal" level). Things to look for are symptoms such as weight loss, night sweats, swollen glands (disproportionately on one side of the body), weakness and fatigue. I would not worry, live your life, keep the HIV suppressed and keep up with your routine visits, let your doctor know if anything changes in your body.

Best, Joe

severe drop down in cd4 and increases viral load: should I start treatment soon?

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