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CD4(%) increasing without meds
Mar 20, 2008

Dear Dr. Bob! Im writing from my lovely Buenos Aires, Argentina. I always read your answers as they really teach me and make laugh as well. I was diagnosed positive 2 years ago, but I think I acquired the virus 3 years ago. My absolute and % CD4 count are(each 3 month) : 390(32%); 628(29%); 394(24%) ; 600(30%) ; 652(26%) ; 653(27%) ; 564(28%); 640(35%). My corresponding VC are: 10,728; 1,375; 2,765; 7,609; 4,894; 5,353; 5,954; 3,922. As you can see, there seem to be a consistent increasing tendency in CD4 % count during last year, while the absolute CD4 count seem to be more stable, as well as the VC. Im not on medicine yet, and have almost a perfect health. Do you think this is reasonably? The increase from 28% to 35% last quarter seem to be too good to be true! The laboratory where I do my tests is a serious one (Fundacion Huesped), so I am confident about the results. Can my immune system be learning how to fight the virus, and being more effective as time goes by? Or the magnitude of the variation of these results are rather common? Im not a fanatic of healthy way of life, but I dont use drugs nor abuse of alcohol (only good red wines with our "asados" ;)). I am rather stable emotionally speaking to explain the CD4(%) variation by emotions. What do you think about it? I hope you are really fine and wait for your comments from the very south of the continent! Kind regards, Alejo

Response from Dr. Frascino

Hello Alejo,

I'm not convinced that what you are seeing over the past year really qualifies as a consistent increasing trend. The percentage change for the first nine months is minimal (26%, 27% and 28%). Certainly the most recent value of 35% is more significant, but that value may be an outlier. As you note, your absolute CD4 counts and viral loads are essentially unchanged. Consequently your change in CD4% is most likely due to a change in other related parameters. You'll need a few more data points over the coming months before being able to confirm a trend. What we can say at this point, looking over your two years of laboratory results, is that your condition has remained reasonably stable, both immunologically (CD4 counts) and virologically (HIV plasma viral load) off meds. This is good news, as it means medical intervention (HIV meds) is not warranted yet. HIV disease, in most cases, is a very slow process. Continue to monitor your counts every three months while you continue to enjoy all the charms of Buenos Aires. (It's one of my favorite cities in the world, by the way.) You can learn more about HIV monitoring tests (CD4%, etc.) in the chapter "HIV Testing Basics," which can be easily accessed on The Body's homepage under the heading Quick Links. Within the HIV Testing Basics chapter there is an entire section on "HIV Monitoring Tests Basics."

Brindaré por tu buena salud con un excelente tinto. ¡Está bien de salud!

Dr. Bob



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