dissapointing reults

[St Ives]

hello good people.
just got emailed latest results and feeling a tad blue..!
VL <40, %CD4 6, ABSOLUTE CD4 127. After 4 years on atripla that's pretty weak.
What I don't understand is MCH...34.7,  MCHC...37.1  can anyone explain what that means ?  It's printed in red so it may be a problem.
I've been on atripla since the start, do you think I should change meds? I see the doc in 3 weeks, What should I be asking him, any advice?
I really would appreciate your thoughts on this.
Be well.

[AusShep]

Your hemoglobin is slightly high, probably not a big deal, doesn't look very far above normal.

For whatever reason people here seem to ignore the multiple studies that have shown improved CD4 recovery with protease inhibitor regimens over NNRTI regimens; "there's nothing you can do" seems to be the party line.  I've not seen that these studies have been discounted, but it is possible.  Integrase inhibitors may be even better.

Link below from a recent univ of Washington discussion.  They reference studies showing better cd4 recovery on PIs vs efavirenz but say there is little evidence that switching will help (I'm not aware of studies on switches when VL is suppressed), so the party line may be correct, or may just not be studied enough.

http://depts.washington.edu/hivaids/arvrx/case5/discussion.html

In your situation, I'd investigate a switch after the amount of time you've gone with such a slow cd4 recovery, but you could be one of the people that never gets (or possibly ever had) high cd4 counts. 

There are others in your situation that are doing just fine, you have undetectable viral load, that's what is most important.

[bocker3]

As to your RBC indices (MCH and MCHC) - these results don't mean much at all.  Though they do NOT mean your hemoglobin level is high.  Your HGB will tell you that.  The indices really tell little other than, possibly, helping to identify a cause of anemia (if you are, in fact, anemic).  MCH simply tells the average amount of HGB in a RBC and the MCHC the amount of HGB in the cell relative to its size.  They are both calculated.  I believe MCH is HGB/HCT and MCHC is HGB/RBC.

MCHC is often elevated in smokers........  just an interesting, yet clinically insignificant fact.

So.....  don't even bother looking at these results.  If your HGB is in range, there is nothing at all to be concerned with.

Mike

[absopozilutely]

If you've read my story a bit maybe you'll come join the Stribild bus. No side effects but I do miss Complera.