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HIV Drug ResistanceHIV Drug Resistance
          
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Falling CD4 count
Jun 30, 2004

My labs in Jan. '04 were undetectable V/L and CD4 was 503. My latest labs this month were undetectable and 393. I did my lab work a week after major surgery (replaced 2 disks in neck & rt. hand carpal tunnel). Could this cause the blip in my CD4 count? I don't meet with the doctor until late July to discuss these results and I am concerned about the 21% drop. Should I be? Thanks for all of your help. It is appreciated tremendously. Jeep

Response from Dr. Sherer

At the higher range of CD4 cell counts, i.e. >500, there is more variability from week to week, as much as 25%. And, as you suggest, other factors can influence the CD4 cell count, such as other infections. I have no specific information regarding the surgery you have had, but it is reasonable to think that it might be an explanation for a modest decline. Another way to interpret whether this change is meaningful is to compare the CD4 percentage from the Jan and June values. If there was a difference less than 3% (eg from 30% to 28%), it is more likely that the change in the absolute number should concern you. Your doctor will likely ask for a repeat value to aid in the interpretation of this value.

In sum, I would not be overly concerned, as your viral load was below detection in both cases, indicating the your regimen is successfully controlling viral replication. I suggest that you discuss these questions with your doctor at your next visit.


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