Using total lymphocyte count

Question

Hello:

I have been recently diagnosed HIV+ at a "no questions asked" anonymous clinic in Toronto. The diagnosis is a simple negative or positive so I do not have actuals on viral load or CD4 counts. I live in a small community and because of this I have chosen to remain anonymous regarding my status, including to my physician who is also a family friend. I may change this decision in time, but for now this is the easiest way to deal with the emotional impact of the disease. My question is regarding how I can use my total lymphocyte count and WBC counts taken from a standard blood test to monitor the disease progression and make decisions on starting treatment. I understand that this may not be the ideal way to track the disease, but is it at all useful? At the point of starting treatment I will "come clean" to my physician but I would prefer not to presently, especially if I am years away from actually needing treatment. I just had bloodwork done and was told that all numbers (WBC, Lymphocytes, etc.) were normal as well as liver function. In other words, no hidden suprises. My only physical ailment at this point are some generally painful enlarged glands throughout my body which have persisted for about 3 months. Should this not have showed up in my total lymphocyte count? Other than this I have a solid appetite, healthy diet and physique, and no other complaints. I do not have my numbers from the bloodwork with me as I did not ask to keep a copy. I could forward the data later if you would be willing to evaluate it. Thank you all so much for your efforts with this forum, as without it I would truly feel alone.

Regards, Jason

Answer

Dear Jason-

Sorry to hear of your situation.

A very crude way to estimate the CD4 count would be to divide the total lymphocyte count by 2-- this assumes a healthy immune system, with about 50% of the lymphocytes being CD4s.

Frankly, though, in Canada, there is excellent HIV care; particularly in Toronto. I'd not want you to jepardize your health in ignorance of your CD4 count-- perhaps you could get this testing done in the big city.

Good luck and thanks for reading. BY