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Lab result help!
Feb 13, 2014

Hello Doctor,

Last dec I took my mom (in her 60's) for routine check up and since it is her first visit to doctor in USA after immigrating from India they recommend testing for hiv) and she was diagnosed with hiv + and he draw some more blood to check her viral load and it was 103 @ that time - he asked us to come back after 1 month and he will do the complete test and result just came out. Here's her lab result can u pls review: Thank you. I also wanted to let u know that my mother had a bad gastritis otherwise healthy. How can she get exposed to hiv as she is celibate for 10 years. If she is exposed to hiv recently? I can only think is she might have got it from the dentist she visited few months ago in India few (rural - I yelled at her after she told me she went to see him because it is cheap and I am not sure he wears glove n suspect he reuse needle). in dec her cholesterol was 236 and vitamin d was 17 - since she was diagnosed in dec we changed her diet (cut down sugar, white bread etc) and gave her a vegetarian plant-based multi vitamin, mushroom complex, green juice powder concentrate, and astragalus herb. Do you think we should continue with this? Do you think she should start the treatment? Please advise. Thank you in advance for all your help and support.

HIV-1 AB,WESTERN BLOT Positive Negative VIRAL BANDS OBSERVED p24,p31,p40,gp41,p51,gp120,gp160

Ordered Date: 01/25/2014 Assessments: HIV positive, asymptomatic Lab: LYMPHOCYTE SUBSET PANEL % CD3 (MATURE T CELL) 78 ABSOLUTE CD3 CELLS 2568 % CD4 (T HELPER CELL) 23 ABSOLUTE CD4 CELLS 767 % CD8 (SUPPRESSOR T CELL) 52 ABSOLUTE CD8 CELLS 1752 HELPER/SUPPRESSOR RATIO 0.44 % CD19 (B CELL) 12 ABSOLUTE CD19 CELLS 394 % CD16+CD56+ (NK CELL) 9 ABSOLUTE CD16+CD56+ CELLS 307 ABSOLUTE LYMPHOCYTES 3239

CYTOMEGALOVIRUS AB (IGG) 4.95

TOXOPLASMA IGG AB <0.91

Lab: COMP METAB PANEL W/EGFR GLUCOSE 97 SODIUM 144 POTASSIUM 4.4 CHLORIDE 109 CARBON DIOXIDE 23 UREA NITROGEN 16 CREATININE 0.63 BUN/CREATININE RATIO NOTE CALCIUM 9.3 PROTEIN, TOTAL, SERUM 7.7 ALBUMIN 4.5 GLOBULIN,CALCULATED 3.2 A/G RATIO 1.4 BILIRUBIN,TOTAL 0.6 ALKALINE PHOSPHATASE 75 AST 21 ALT 20 EGFR NON AFR AMERICAN 95 EGFR AFRICAN AMERICAN 111

VITAMIN D,25-OH,LC/MS/MS VITAMIN D, 25-OH, TOTAL 25 VITAMIN D, 25-OH, D3 25 VITAMIN D, 25-OH, D2 <4

HSV 2 IGG, AB HERPESELECT >5.00

HSV 1 IGG, AB HERPESELECT 3.95

HIV-1 RNA,QN BDNA(V3.0)NY COPIES/ML (VERSION 3.0) <75 LOG COPIES/ML(VERSION3.0) <1.88

NEG REFLEX 35292X HIV-1 WB NY EOI REFLEX

Hypercholesterolemia NOS Lab: LIPID PANEL CHOLESTEROL,TOTAL 222 HDL CHOLESTEROL 63 CHOLESTEROL/HDL RATIO 3.5 LDL CHOL, CALCULATED 148 TRIGLYCERIDES 56 NON HDL CHOLESTEROL 159 mg/dL

Lab: HSV 1/2 AB (IGM),W/RFL(S) Name Value Reference Range HSV 1 IGM SCREEN Negative Negative HSV 2 IGM SCREEN Negative Negative

Response from Dr. Young

Hello and thank you for posting.

Sorry to learn about your mother's health- her labs clearly indicate that she does have HIV infection. It's impossible to tell based on her labs when she acquired the infection- CD4s and viral loads simply can't predict this.

It's important that she have a good diet, with sufficient calories, minerals and vitamins- but supplements are the worst way to achieve this. Rather, I'd suggest a good balanced diet and only if she's not able to do this, then take vitamins.

Her other labs show normal kidney and liver function, though her LDL (aka bad) cholesterol is quiet high. This might prompt a discussion with her care provider about means to lower her cholesterol, including diet and medications.

Your mother has a relatively well preserved CD4 cell count and percentage, so based on current World Health Organization (but not US governmental) guidelines, she can defer on starting HIV medications for now.

I hope this is helpful, and please feel free to write back. BY



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