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Cd4 cell count answers (1698)

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Q: 

cd4 & CD8 Percentages

A: Response from Dr. Young Peter, thank you for your question. It''s rewarding to this writer to know that we''re reaching readers in Hong Kong. CD cell percentages are another metric of immune cell levels. Since total cell counts fluctuate, the percentage of the total population that is cd4 or CD8 tends to be more constant, and hence, less variable from day to day. I use both absolute and percentage cd4 counts in assessing my patients'' health, and when there''s discordance between the two, I weigh the cd4% as a more valuable (and as we''ve seen above, less variable) measure of immune health. In...


Q: 

Starting meds with a lower cd4 count

A: Response from Dr. Wohl It is unclear how the prognosis of a person with a cd4 cell count that falls below 200 but then rises to high levels on HIV therapy is different from another whose cd4 is keep high with meds. Your friend is correct in that there can be lasting damage done to the immune system such that the full repertoire of responses to organisms may not be present. However, to what extent these deficits affect prognosis is not clear and they likely vary significantly by person. DW...


Q: 

Slow to test cd4 and viral load

A: Response from Dr. Young Claudia- Thank you for your post. I am very sorry to hear about your husband''s diagnosis. The fact that your husband has toxoplasmosis indicates that he has a very low cd4 count (usually below 100)-- I wouldn''t need a laboratory confirmed cd4 count to initiate therapy in this circumstance. Clearly there are some differences in how doctors practice medicine in different countries-- sometimes these differences reflect different opinions, other times relate to the availability of medications and diagnostic testing. So rather than insisting on a cd4 cell count, I''d want...


Q: 

cd4 & Sickness

A: Response from Dr. Young Thanks for your post. Yes, the whole point of HIV treatments is to increase the cd4 cell count. In general terms, this happens because medications prevent HIV-mediated cd4 cell death, and thereby allowing the body''s normal replication of cd4s to continue. With a cd4 count of ~450 and relatively low viral load,assuming that you''re asymptomatic, I would not be strongly recommending treatment. Good luck, BY...


Q: 

Undetectable but T-cells failing to rise

A: Response from Dr. Wohl I have seen a couple of patients who had an undetectable viral load but declining cd4 cell count. On further testing we found they had HIV-2, a type of HIV that is found mostly in some parts of western Africa and Carribean. We altered the medications to those with more of a track record against HIV-2 and saw better results. To detect HIV-2 an antibody test that only looks for antibodies to this virus and not HIV-1, the major type of HIV worldwide, needs to be done. The viral load test may not always pick up HIV-2. If this is not the cause of your low cd4 count and you are in the US you should try and get to one of the federally funded AIDS...


Q: 

New to treatment cd4- 66

A: Response from Dr. Young Thanks for your post. Yes, tenofovir/FTC (Truvada) with lopinavir/ritonavir (Kaletra) should be a very potent and well tolerated drug regimen. It is a very highly recommended regimen in the most current US treatment guidelines. Many of our patients elect to start treatment with one of the newer boosted protease inhibitors even in the face of lower pill burden non-nuke regimens (eg, substituting your lopinavir/ritonavir with efavirenz (Sustiva, Stocrin)-- this is because of the potential benefits of prevention of drug resistance and efficacy, even in the event of transmitted drug resistance. Side effects for most patients are mild and not a reason for treatment discontinuation. As with any HIV treatment regimen, a small percentage of patients can develop side effects...


Q: 

HELP!! T cells are lost

A: Response from Dr. Young Thank you for your post. I''m sorry to hear about your mother''s diagnosis. She indeed has a very low cd4 cell count and advanced AIDS. Without antiretroviral medications, her long-term prognosis is not a good one. By contrast, if she (and her doctor) can assemble a potent, tolerable combination treatment that she can adhere to, I''d think that her prognosis is anything but hopeless. The difference in these two possiblities is huge, most depends on her treatment options. Write us back if you can tell us more about your mother''s past treatment history, I''d be happy to review in greater detail. BY...


Q: 

Relation between cd4 count and Viral load

A: Response from Dr. McGowan Thanks for your compliment and your question. The viral load is the amount of virus in the liquid portion of a drop of blood. The cd4 count is the number of cd4 cells also in a drop of blood. The cd4 cells are infected by HIV and their numbers can drop over time due to HIV infection. The cd4 cells are white blood cells, also called ''helper cells'' that keep the immune system in proper balance. When their numbers go down the immune system cannot effectively block infections and AIDS can result. Usually, the higher the...


Q: 

Starting meds with high cd4

A: Response from Dr. Wohl Dear Tadeusz, Your instincts are correct, your doctor does not know what he is doing. You should not start HIV medications. Your cd4 cell count is high and there has been not demonstrated benefit to initiation of treatment at a cd4 cell count at your level. Need verification? Check out the U.S Public Helath Service Guideline at http://www.aidsinfo.nih.gov/guidelines/default_db2.asp?id=50 Si,ilar treatment guidelines are available from the World Health Organization (WHO) and the Iternational AIDS Society (IAS). Most clinicians do not consider starting HIV therapy until the cd4

Q: 

One Month cd4 Increase

A: Response from Dr. Wohl I understand your eagerness to see results quickly. However, this 30% rise is not out of the ordinary and is quite respectable. A month is really not much time and I suspect you will continue to see increases. When looking at changes in cd4 it is helpful to look at both the absolute cd4 number (the actual number of cd4 cells counted in a drop of blood) and the cd4 percent (the proportion of white blood cells that are cd4 cells). Changes in absolute cd4 cell counts should...


 
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