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cd 4 ??
May 9, 2009

HI, dr.Bob.

thanks for answering my question. just to let you know i have not tested positive on the elisa or viral. i will test again very soon. the only thing i cant understand is that i have not made antibodies yet. viral undectable due to high cd 4 count . i understand. no antibodies due to ?? . let me guess, 1. im not infected 2. different strain 3. my body is doing ok ,so its not mounted antibodies yet. well, as for as my symptoms, i just have a fungal in between my butt cheeks. i had for about six months, slowly getting worse. well thanks again, im constantly looking at this site, your very funny . one more thing. so even a negative person can have a drop of cd 4 around 500 like me. that is my real question.

Response from Dr. Frascino

Hello,

You've never tested HIV positive??? Then why the hell are you lurking around this site and getting periodic CD4 counts and HIV plasma viral load tests???? Dude, you have some serious issues.

Actually I had a sneaking suspicion this might be the case from your initial question (see below) after reviewing your laboratory results. Note the very first line of my response: "Are you HIV positive?" Apparently my suspicions were correct. You are not HIV infected. Rather you are merely wasting money, energy, blood and resources getting expensive tests that are totally unwarranted.

Most likely what you have between your butt cheeks is a common fungal rash (the equivalent of a diaper rash!). Go see a dermatologist and stop the insanity of chasing after a disease you obviously do not have.

Dr. Bob

cd 4 course May 8, 2009

dr.bob,

i got a cd 4 count a year ago, it read 49% cd4 and cd4 1564, now a year later it reads 48% and cd4 1086, i believe with cd 4 count being so high is the reason why i am still hiv viral undectable. losing about 500 cd4 in a year is that bad. also losing 1% is that bad or normal? thanks

Response from Dr. Frascino

Hello,

Are you HIV positive? I'll assume you are since this is an HIV information Web site.

Are you on antiretroviral medication? If so, they are working well both immunologically (keeping your CD4 cells high) and virologically (keeping your viral load undetectable). If you are not taking antiretroviral medication and are confirmed to be HIV positive and have a persistent undetectable HIV plasma viral load, you would qualify as an "elite controller." That is an HIV-infected person who can control HIV replication without anti-HIV medications.

As for your specific question, a drop of 500 CD4 cells (or decline from 49% to 48% in CD4%) is considered normal variation in your current range. In other words even with a drop of 500 cells you are still in the "normal range" for CD4 cells. It type of variation, up or down, within the normal range is not a bad prognostic sign. CD4 counts can bounce up and down for a wide variety of reasons other than HIV. You'll need to monitor your counts over a period of time and look for trends. Right now you appear to be doing extremely well.

Be well. Stay well.

Dr. Bob



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