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Cd4 cell count answers (1698)

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Q: 

Wimpy Question but Please Answer!

A: Response from Dr. Pierone Actually, the problem you describe with swallowing pills is much more common than many people realize. Some HIV medications come in liquid form and most others can be crushed - so not to worry. A cd4 count of 350 years after infection is probably a little better than average, but certainly within an expected range. Thanks for posting and best of luck of luck to you....


Q: 

worried about labs

A: Response from Dr. Wohl It seems like there was a decline in your neutrophil counts even before you started your HIV meds. Therefore, it is hard to pin this on your HAART just yet, especially as these meds are not particularly know to drop white blood cell counts. I agree with your concern about infection. We don''t like the neutrophils to dip below 500 but it is not like you will be at much greater risk at a count of 500 than 630. I would recommend that you be referred to a hematologist for a comprehensive evaluation if the low counts continued as there are many potential causes for this other than cancers including vitamin deficiencies, autoimmune processes and HIV...


Q: 

Is Leukemia possible?

A: Yes Leukemia can cause low white cell counts. But, it may not show up on a regular CBC. If the doctor is concerned about Leukemia, there are more intensive tests that can be done. The other cause of low white cell counts and lumps is immune disorders, lupus, allergies, stress, and certain drugs such as Ibuprofen(advil) aspirin etc. will lower the counts. The most often thought about by medical providers is HIV, but that involves counting the cd4 cells and that is another process different from the routine CBC as well....


Q: 

clinical trial qualification

A: "CD" (cluster of differentiation) proteins are proteins present on the surface of cells that are used as markers to identify particular cell types. CD3 and cd4 are just two of the hundreds of CD proteins there are. Both CD3 and cd4 are present on T cells, which are a type of white blood cell and are a component of the immune system. I know that T cells are supposed to be somehow involved in psoriasis, probably by being involved in the autoimmune reaction that causes the lesions of the condition, but I don''t know more than that. The trial might involve somehow inhibiting T cells as...


Q: 

when is better to start medicins?

A: Response from Dr. McGowan Thanks for your question. Thoughts on when to start treatment are changing now. In the US the guidelines recommend starting treatment at 500 cd4 cells, however half of the expert panel felt that treatment should be started above 500 cells. Really it is an individual decision. We are learning that allowing the virus to grow causes inflammation and direct infection of cells that can damage organs of the body, including the brain. There is a study, called START, that is looking to find the best time to start treatment. If a person is willing to take treatment and be adherent to it, I would trteat at a high cd4 count....


Q: 

is it time for meds?

A: Response from Dr. Young Thank you for your question. The question of when to start therapy for HIV has become somewhat controversial lately. In the past, most clinicians would definately start therapy in persons with cd4 counts below 500 cells, particularly those with viral loads like yours, over 50,000 copies. Recent opinion has become more conservative, with the breakpoint for initiation of therapy lowered to 350 cells. Nevertheless, I would sum up your situation as someone with mildly symptomatic (thrush) disease with relatively high viral load and moderate depletion of cd4 cells. If you were in my clinic and were willing to start therapy,...


Q: 

now what?

A: Response from Dr. Young Thanks for the question. It is nice to hear back from you. Sounds like you''ve had an excellent viral load response; you cd4 count increase is large, though I''d be interested to know if the cd4% increased in similar magnitude. As for the next tests, I''d key into seeing if the VL decreases further; I might not expect (at least initially) for another 100 cd4 cells (though you might see increases in cd4% or decrease in CD8%). Keep up the excellent adherence work, best wishes. BY...


Q: 

What do I do next..

A: Response from Dr. Young Thanks for your post. Current treatment guidelines suggest starting treatment if you develop HIV-related symptoms (regardless of cd4 count) or when your cd4 count is reproducibly below 350. Some would also consider tretament if your viral load is high (above 100,000 copies). As to when you''ll need to start, based on what you''ve listed, it''s likely to be some time, probably several years. The only way to protect yourself from unplanned disease risk is to get regular laboratory monitoring. Hope this helps, BY...


Q: 

What would you do if you were me?

A: Response from Dr. Wohl I can''t tell what is going on. You have symptoms but it sounds like form your emails that all objective measures of your health are normal. For instance your T-cell counts are totally normal. In addition, some very good physicians have seen you apparently without any result that you find satisfactory. I know you are frustrated. But, maybe you are going about this in exactly the wrong way. Instead of going to doctors who specialize in the one disease we know you do NOT have (HIV) maybe you need to try and see someone who has a broader perspective. For example, your sed rate being up (how up?) may lead me to suggest a rheumatologist to evaluate for a connective tissue disease. If you do not have one, you absolutely...


Q: 

CCR5 and CXCR4

A: Response from Dr. Wohl As you mention, there is a tendency for there to be switch among the HIV in a person''s body from fitting well with the CCR5 receptor of the T-cell to another receptor, the CXCR4. The chance of this switch increases as the T-cell count drops and for a period there is a mixture of virus that favors each of these receptors. That said, many people with very low T-cell counts can still have almost exclusively CCR5 favoring virus. A consequence of this phenomenon of the evolution from CCR5 to CXCR4 is that CCR5 blocking agents may work best in people with virus that is CCR5 tropic (i.e. likes to use CCR5 to gain entry into the T-

 
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