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Cd4 cell count answers (1698)

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Q: 

Average Rise in cd4 count

A: Response from Dr. Wohl The rate at which cd4 cells return after the initiation of HIV medication is variable and depends on several known and unknown factors including what your count is before starting the medication. Generally, the lower the cd4 cell count is before starting treatment the less robust the response. This is most true for those who had counts below 100 prior to HIV therapy. In addition, many people with the lowest counts get an initial rise in cd4 cells but then hits a ''ceiling'' usually below 200

Q: 

How come: low VL yet low cd4!

A: Response from Dr. Wohl Ah, to understand why a cd4 (T-cell) count can be low even though the viral load is low is to understand what these tests are all about. The viral load predicts how fast or slow the cd4 cell count falls after infection. The higher the viral load, the faster the cd4 cell count typically falls. Viral load generally stays about the same for most of the course of the infection in the absence of HIV therapy (the value can fluctuate by about three-fold due to biological and laboratory variability). So, if your viral load is around 5,000-10,000 this is...


Q: 

cd4 droping 300 cells in 30 Days?

A: Response from Dr. Wohl Dear Duke, I suspect your cd4 decline is a result of your chemo over the summer. Chemo kills cells, bad ones and some good ones. I have seen this in many cases in which my patients underwent chemotherapy and it is practically expected. So, I am not certain your KS is a result of the drop in cd4 cells. Rather, I suspect you had cutaneous (skin) KS and also some internally. The Doxil was not sufficient to eradicate the KS inside your body but did drop your cd4 cell counts. You can expect a repeat in the cd4 cell count drop...


Q: 

debilitating syphilis and t cells

A: Response from Dr. Pierone Hello, I do not know of studies that have looked that effect of syphilis on cd4 counts but it is plausible, possibly expected, that it might bring cd4 counts down. It almost always makes sense to get more than one cd4 count before starting therapy because these counts can vary so much. At the very least you get a better sense of baseline immune status. In your situation it might be helpful to see what trajectory of your cd4 cells as you recover from syphilis as well as the surgery and skin grafts. The other reading that might be helpful is the...


Q: 

weight and cd4

A: Response from Dr. Young Dear Nerve, Thanks for your post. I can''t tell you exactly why your cd4 cell count hasn''t risen- though you raise an interesting point about your weight and the dose of your medications. Fortunately, in most circumstances, the viral load is a highly sensitive way of checking to see if the drugs are sufficiently potent. Not knowing which medications you''re taking makes it more difficult for me to be sure about whether the doses are appropriate or not. I''ve uses situations like yours, at times, to obtain drug level testing (therapeutic drug monitoring, TDM) to verify that the correct amount of drugs is reaching your blood stream. There is a new drug-drug interaction between tenofovir...


Q: 

splenectomy and increase of cd4

A: Response from Dr. Wohl You are correct, after removal of the spleen the cd4 cell count can rise significantly. This does not mean that the extra cd4 cells are not doing something good for you. As you can tell by your cd4%, you still have a nice number of cd4 cells available. I think your risk for opportunistic infection is low and would not worry about CMV. If tests for parasites in your stool are negative, then this is not a likely cause of your GI problems. Viracept causes diarrhea and if you remain on that med a change should strongly be considered. Beside a change in HIV meds, I would not...


Q: 

Falling viral load and cd4''s

A: Response from Dr. Wohl Your cd4 cell count is not clearly dropping but seems to be bouncing around if you look at the cd4 percent which have ranged from 23% to 29%. I wonder if yoru staph infection and treatment could have lowered your overall number of white blood cells leading to a low absolute cd4 cell count and only a modest dip in the cd4 percent. I''d continue to follow the trends in your cd4 counts before I would react. DW...


Q: 

Advice on cd4 count

A: Response from Dr. Young Karen, thanks for your question. I wouldn''t find that the change from 52 to 46 cd4 cells is of significance- I''d have you look at your friend''s cd4 cell percentage to see if there were any changes there, since the later stat is often a more reliable way to track changes in cd4 cells during therapy. Yes, intercurrent illnesses, like MAC or even herpes can influence the cd4 cell numbers. The key point is that his viral load is undetectable- this is most often the best predictor of intermediate-term prognosis. Overall, the situation for persons with

Q: 

Tcell counts

A: Response from Dr. Young Thanks for your question. There are several factors that are important to consider when looking at your T cell level. First is to be aware that the ''normal'' level differs from person to person. Many clinical labs have lower limits of normal as low as 350 cells. Indeed, by definition, 5% of the population has ''normal'' values outside of the normal range. So it might be that 300-400 cells is normal for you. It is also important to look at other immune parameters, such as cd4 percentage. Some persons with HIV simply have lower levels of all white blood cells; in these individuals, the total cd4

Q: 

Your response ref a normal cd4 count

A: Response from Dr. Wohl If you went to the mall and drew blood for cd4 testing from the first few hundred people you happened upon and averaged the result, the number you would come up with would be closer to 1000 than 500. There are people without HIV infection who have lower than normal cd4 cell counts (that is people with cd4 cellcounts that are abnormally low). I see this all the time in patients in the hospital who have chronic or serious illnesses. In addition, there is an idiopathic (i.e. unexplained) immunodeficiency syndrome during which cd4 cell

 
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