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Cd4 cell count answers (1698)

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Q: 

Benefit from Beginning HAART with cd4''s 300-350?

A: Response from Dr. Wohl Dear Kaeb, There is currently some debate about at what exact cd4 cell count is therapy best started. The data are pretty clear that if you start at a count below 200 your chance of having something bad happen is higher. The data get a bit murkier when we are talking about counts between 200 and 350. Part of the problem is that the studies we are being guided by were designed to answer other questions and are limited by relatively short term follow-up. For many starting at counts around 300 or so provides a bit of a comfort zone before the 200 line in the sand. And, some (but not all) studies do show benefit when HIV...


Q: 

A Nightmare / Unexpected diagnosis w/ cd4 at 109

A: Response from Dr. Wohl The good news is that we HIV docs consider a cd4 of 109 to not be all that bad a place to start from. We have learned from experience that people with such counts can respond remarkably well to HIV meds - meaning a great rise in cd4 cell count. Your viral load will either be high, low or in between. Regardless, you need to start meds and they will work. The key is to take them everyday. The meds prescribed to you are relatively easy to take, Sustiva can be a bear in the beginning as it can cause some vivid dreams, imbalance and an ''out of it'' feeling. This typically goes away after 4 weeks (not a short period of time, I realize). Don''t get...


Q: 

Just diagnosed, BAD counts, Dr. pushing research on me

A: Response from Dr. Wohl There are several issues that you raise: Should you start HIV therapy now? Yes. But a 3 week delay is not a big deal. Your cd4 cell count is unlikely to change much at all in that short period of time. Your numbers, while not great, are not horrible. A cd4 cell count of 20 and viral load of 600,000. Horrible. What should you start? All the listed combinations look good. Combivir is twice a day and Truvada is once a day. That can be important for people who may have trouble taking meds more than once daily. One recent study conducted by the makers of Truvada has shown both Combivir and Truvada, when each is combined...


Q: 

Improved cd4?

A: Response from Dr. Young Thank you for your questions. While I typically use a more direct measurement of cd4 cell counts, one can get a rough estimate of cd4s by examination of the total lymphocyte count, as you suggest. In your wife''s case, the improvement in total lymphocyte count is suggestive of improvement in cd4 counts. It is also reasonable to suggest that there might also be improvement in the cd4%, perhaps by 1-3% in the first two months of treatment, yielding an extrapolated cd4 absolute count that is...


Q: 

Worried about cd4 down

A: Response from Dr. Wohl Hi Bob- I ned a bit more info in order to answer your question. Do you know if his cd4 cell count has changed since starting HIV treatment? When did he start his therapy? What is his cd4 cell count now? When looking at the cd4 count note the absolute count and the percentage of his lymphocytes that are cd4 cells (cd4%). DW...


Q: 

Re: My cd4 count, Sept 19 Question

A: Response from Dr. Wohl Absolutely. This is an interesting study that I do not believe has opened as of yet to enrollment. It requires a cd4 count You can find a participating clinical center at the website listed. DW...


Q: 

cd4s jumped 300 pts and viral load increased 100,000??

A: Response from Dr. Young Thank you for your question. Assuming that you don''t have any ongoing symptoms, I would not recommend starting therapy at this point. The higher viral load and cd4 cell count is probably within the range of day-to-day variability of the test (and the natural history of HIV)-- having additional tests often give the patient and doctor a sense for how things may change over time. Additionally, the higher viral load, if confirmed does suggest the possibility that you''ll need to start therapy sooner than the average newbie; but it''s really the rate of cd4 cell decline (look at both the absolute cd4

Q: 

Sustiva+Kivexa.. no change in cd4

A: Response from Dr. Wohl I would not be too concerned about your brother''s stable cd4 cell count. For one thing, it is fairly high at 500 and 32%. Second, his viral load is undetectable, so the regimen is indeed potent. Lastly, another combination is unlikely to change the situation. I doubt any of the HIV medications he is taking is suppressing his cd4 cell count. Other medications, such as Bactrim or Septra, can occassionally hold back cd4 cell gains. I would leave this treatment alone and keep tracking the numbers as you are doing. I suspect he will do fine. DW...


Q: 

Huge change in cd4, treatment still warranted?

A: Response from Dr. Wohl I would wait. Your cd4 cell count is high and your viral load is low. The change in your counts from November to January are not necessarily an indication of recent infection as your cd4% actually dropped and the viral load was essentially the same. The absolute cell count can vary quite a bit, especially at high counts. There is no indication for HIV treatment now unless you have major symptoms due to the virus. Any attempt to treat you now should be considered outside the box. Were you to have a significant and sustained decline in your cd4 (by...


Q: 

cd4 count dropping rapidly

A: Response from Dr. Pierone Hello, thanks for posting. I''m sorry to hear about your new diagnosis of HIV infection. Sometimes immediately after infection there is a rather precipitous decline in the cd4 count which subsequently rebounds on retesting. The only way to know for sure is to have some follow-up testing of both viral load and cd4+ lymphocyte counts in order to establish a longer term trend. Once you have some additional readings please let us know. Good luck!...


 
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