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Re question you answered on AIDS.
May 24, 2001

Doctor Young thanks for all you great work on this site.I just read your response to the questions AIDS.I was diagnosised with AIDS Last year in April.Had tested neg in March 99.My numbers CD4 234 VL 5000 Lymph 8.3 months later i was diagnosised with an advanced NHL,oncologist believes had been cooking 6-8 months.If i understand your response a low VL dosen't damage the CD4 cells as quickly,so did the NHL destroy my CD4 and Lymphocyctes? Its not clear to me how a 5000 VL did so much damage in one year.I know how i was explosed and it was within that year between March and April.Is it possible just to have had real bad luck and got both at about the same time.After starting meds was undectable within 10 weeks and have remained that way.CD4 are high 200's but I am still doing chemotherapy.I know I 've been branded as an AIDS patient,but NHL also destrys Lymphocytes which if I am correct are cd4.Thank you.

Response from Dr. Young

Thanks for your comments and question.

Non-hodgkin's lymphoma is one of the AIDS-related complicatons that does not always come with CD4 counts below 200; it is important to note that your CD4 count is close enough to 200 that either way, you have fairly advanced disease with immune suppression.

People with low viral loads typically do have progessive immunosuppression, albeit with lower rates. Unfortunately this is a general statement and some progress more rapidly than others. You raise the question as to whether NHL caused a more rapid decline in CD4s than expected. I am not aware of any studies that address this question in HIV, though we usually consider patients with cancers to be more immunosuppressed than people without. Hence, it might not be unreasonable to think that your current CD4 is the result of both HIV and NHL.

The other point that is relevant to your case is that many cancer chemotherapy drugs cause the suppression of the production of all blood cell types. If this were the case you might expect to see a relatively low total white and red blood cell count; but preservation (or relative preservation) of the CD4 cell percentage. Normally a CD4 count of 234 would be expected to have a CD4 percentage of around 15 or 16. If your percentage is higher, it might mean that your general immune function is probably better than the number 234 would suggest.

I hope this helps, good luck. BY



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