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cd4 bajaron de 440 a 292 en solo 1 mes.
Aug 22, 2012

Estimado Dr, que significa una caida de cd4 de 440 a 292 en solo 1 mes, me infecte hace aproximadamente 5 meses, la carga viral en 47000 copias bajo desde 359000 copias hace 1 mes, como se explica baja de cd4 y baja de c.viral tan pronunciada, mis % cd4 en ambos estudios 16%, por otro lado mi medico me receto para iniciar atripla, y sugiere un tratamiento ya mismo precoz, tengo 43 años, y sano de todos los parametros del hemograma y no padezco ninguna otra enfermedad, no fumo ni bebo, es posible que al tratarme antes de los 6 meses de la infeccion al cabo de unos años pueda mi organismo por si solo controlar la infeccion o por ser ya infeccion cronica debo medicarme de por vida?, que ventaja a nivel inmunologico o salud tengo por iniciar tratamiento antes de los 6 meses de la infeccion? podre recuperar lo deteriorado de mi sistema inmunologico en su totalidad, que % de cd4 y que valor absoluto se concidera normal para una persona hiv negativa?, podria tener una expectativa de vida igual a una persona hiv negativa si tengo una adherencia perfecta al tratamiento?, un saludo y le agradezco por su gran ayuda.

Response from Dr. McGowan

My best translation: Dear Dr, What is the meaning of a drop in CD4 from 440 to 292 in just one month, I got infected about 5 months ago, viral load 47,000 copies from 359,000 copies in 1 month, as explained low CD4 and low c. viral so pronounced, my cd4% 16% in both studies, on the other hand my doctor prescribed me to start Atripla, and suggests early treatment right now, I am 43 years old, and healthy in all the parameters of the hemogram and I do not suffer any other disease. I do not smoke or drink, you may to treat before 6 months of infection after a few years my body can alone control the infection or chronic infection and should I be on medicine for life?, that advantage at health immune or I have to start treatment before 6 months of infection? Will I be able to recover the damaged my immune system as a whole, that% CD4 and absolute value is normal for a person concidera hiv negative?, could have a life expectancy equal to a negative hiv person if I have perfect adherence to treatment? , greetings and thank you for your great help.

Res:

Es bueno que se diagnostica a tiempo, cuando su recuento de CD4 era bueno. El tratamiento temprano es ahora muy recomendable. Será mejor que puede preservar la función inmunológica mediante el tratamiento antes. La caída de los CD4 con un% de CD4 estable repersents la normal hacia arriba y abajo que esperamos de los recuentos de CD4. Nos solamente medir los CD4 en la sangre, y la mayoría de las células viven en los órganos, no en la sangre. A CD4% de 16 es consistente con tener un recuento de alrededor del 300 por lo que esta es consistente. Si te quedas en medicamentos y mantener la supresión del VIH que no hay daño en hospedándonos en medicamentos de por vida. Con un recuento inferior a 500 que es el momento adecuado para empezar, a la espera sólo añadiría unos meses sin medicación, que no es importante durante toda la vida. Usted puede esperar un buen aumento de CD4 y puede planificar una esperanza de vida normal.

It is good that you were diagnosed early, when your CD4 count was good. Early treatment is now highly recommended. You can better preserve your immune function by treating sooner. The drop in CD4 with a stable CD4% repersents the normal up and down that we expect from CD4 counts. We only measure the CD4 in the bloodstream, and most of the cells live in the organs, not in the blood. A CD4% of 16 is consistent with having a count around the 300s so this is consistent. If you stay on meds and keep your HIV suppressed there is no harm in staying on meds for life. With a count below 500 it is the right time to start, waiting would only add a few months without meds, which is not significant over a lifetime. You can expect a good increase in CD4 and can plan for a normal life expectancy.

Best, Joe



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