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large CD4% increase
Mar 14, 2012

Dear Dr McGowan,

After discovering of my HIV status, following infection within a 6 mth window, I quickly started meds. I am now on Kivexa and Stocrin. I have had a very good response to my meds and my lab work is now normal and within applicable ranges. I am a 45 years white male with IDDM for 25 years.

I have a question re my CD4 count and CD4 %. It seams that my CD4 count has remained stable since starting meds yet my CD4 % has increased greatly from 36% to 51%. (disregarding the Sept 11 results which are skewed due to STD infection).

From your clinical experience is this relatively large increase in CD4% and increasing CD4% something to be concerned about as it is now outside normal ranges? Would you expect the CD4% to continue its ascent? As the CD4 count has remained relatively stable during this period and the CD4% has increased greatly, would you expect that the CD4 counts are actually higher than the results indicate?

Pls review my quarterly results below over the last 15 mths to assist in your response. My WBC is always normally at the lower end of the applicable range.

Thank you for your reply.

CD4/CD4%/VL 482/32%/10K - HIV diagnosis Dec 10 679/36%/6K - Feb 11 started ATRIPLA meds 699/42%/UD - Mch 11 750/43%/UD - Jun 11 445/58%/UD - Sep 11. Viral STD infection. Replaced TRUVADA with KIVEXA to place less pressure on kidneys due to diabetic status. Also at this time had osteopenia diagnosis and increasing plasma creatinine and decreasing eGFR over 6mth period. Calcium and VIT D normal. No protein in urine. 666/49%/UD - Dec 11. CD4/CD8 ratio at 1.4 597/51%/UD - Mch 12

Response from Dr. McGowan

Thanks for sharing your experience.

No I am not at all concerened with these results, this is an execellent response. As you correctly point out the absolute Cd4 count dipped down during an STD infection, because the CD4 cells moved out of the blood and into the tissue to fight it off, but rebounded after treatment. A good lesson to learn about safer sex! The number has stabilized at a normal range. Since your white blood counts run in the low normal range you may not have the absolute number go much higher, bhut then you do not need it to be any higher. Keep up the good work!

Best, Joe



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