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Variotion in CD4 before starting medication
Aug 6, 2011

Hi, First I got my blood work on 21st april 2011, my cd4 came 325 and vl -76k and cd%-14% then i got tested on 30th june 2011 my cd4 went down to 265 and vl 35k and cd% 15.7%. I went to my ID last week to start ART he suggested me to do one more cd4 test to more renown laboratory and This time my cd4 came to 471. My ID advised me to do CD4 test again after 6 months as my ID believes this lab is genuine and previous two reports could be lab error. I am confused the latest lab i went to is surely the most renowned lab in India(I resides in India). Kindly advise me what to do. Thanks a million in advance.

Response from Dr. Frascino

Hi.

No matter which of the three CD4 values is most accurate, I'd recommend you begin antiretroviral therapy! Most guidelines now recommend starting treatment when the CD4 count falls below 500. All three of your tests have been below that threshold. A number of HIV specialists, including yours truly, recommend beginning antiretroviral therapy as soon as someone becomes HIV positive, no matter what the CD4 count is (even if it's well above 500). Early intervention preserves immune function and decreases damaging immune activation/inflammation. You can read more about when to begin treatment in the archives of this forum and elsewhere on this site.

Good luck. Be well.

Dr. Bob



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