CD4 results

[jay4367]

I am an American living in Thailand with my 21 year old Thai partner who recently tested pos for HIV. He has just received the results of his first CD4 test which shows CD4 as 14% and absolute 245. It also shows Lymphocyte as 24% and absolute 1752. The WBC is 7300, Hb 12.9 and Hct. 39.6. I do not understand what all this means except I have read on many websites that treatment should start when the CD4 is lower than 250 absolute and/or 20%. The doctor at the free government has told him that because his WBC is high it is not necessary to start treatment, to wait until he becomes sick. This sounds crazy to me and this reasoning is because the government treatment is free they are trying to reduce cost. We need advice.

[Ann]

Hi Jay,

I would agree with you that with his numbers, especially that low CD4%, it's time to think about meds. It might be that the doc wants more than one result to go by, so you might want to ask about that. I've never heard of a doctor basing the decision to go on meds or not on the WBC count - it's normally the CD4 and viral load that is important.

Please check out the Welome Thread found at the top of the Living With forum. There you'll find links to other parts of this website, like the Lessons. In the Lessons you'll find a section that will explain what all those different lab results mean. If you still have further questions, don't hesitate to ask.

Oh, and welcome to the forum! Please feel free to start a thread in the Living forum to introduce yourself. I look forward to hearing more from you.

Ann

[penguin]

hi jay (and partner), welcome 

current WHO guidelines recommend that people with cd4 counts at or below 200 should be on/offered antiretroviral meds(& prophylactic meds,as available/appropriate) Above this point, (in situations where resources are limited) the decision to treat will be more often based on the presence, type, and severity of symptoms - ie diarrhea, infections, weight loss etc. WBC/lymphocyte counts etc are not very accurate ways to predict/decide need for arv's -  especially when better, accurate diagnostic tools, like CD4 measurements are available, as for your partner.

if this is a first set of labs, & your partner is otherwise well, then as ann says, having at least one more set of results (in the next couple of months if possible) to guide treatment decisions would be useful.

good luck to you both - let us know how things are going

kate

( i did have a nice link to who/thai treatment guidelines, in plain english, but first post didn't work...will have another look for it though)

[felix]

Hi
My counts are pretty shot (CD4 <90), but I look okay, however I have lymphoma (NHL- plasmablastic) and my bone marrow has been given the kick in the bone by chemo recently, sometimes looks aint what they seem.  I have sever problems but cope, but all I'm saying is don't always trust how one looks - if your friend needs help sometimes he may need it but not look  as if he does. Help him with which ever way you can and bless you both - Felix