Strange Lab Numbers - WTF??!!!

[spacebarsux]

Hi guys,

I just received my second lab results, and I have to say I am completely thrown off by how strange they are. I am not yet on meds.

VL- 81,380
CD4- 907 @26%
Absolute CD8- 1791  (Lab reference range 200-1100)
CD4/CD8 ratio- 0.51 (Lab reference range is 0.7- 3.50)

My first set of numbers taken sometime in Feb were
CD4 – 750 @ 34%
VL-39,000

I really don’t know what to make of these results. While the relatively high CD4 is encouraging, the VL increase is disappointing. Also, what exactly is the relevance of such a high CD8 value?

I just want to add that other than being stressed out, I don’t really feel sick or fatigued. Also I do not think I am mentally prepared to go on meds unless absolutely required at this stage. What concerns me is that many experts recommend going on treatment if one's vl is 100,000. Mine is nearly there.

Any insight would be greatly appreciated (especially by Newt and Ann,  if they would be so kind).

Many thanks guys.

[Assurbanipal]

Your numbers are basically unchanged.

A significant change in viral load is 3-fold (one third to three times -- also know as +/- .5 log)

A significant change in CD4 count is +/- 30%

They only take a little sample of your blood, so to extrapolate to your overall health it is helpful to think about each draw as a sample, with a confidence interval around the results. 

Trends over time are helpful, they reflect more samples and therefore a smaller confidence interval.

[Basquo]

I agree, don't decide that you're "nearly there" based on one blood draw. You need to see some trends. The important thing is that you're seeking medical attention regardless of how you feel and not waiting unitl something's wrong. Your doctor can help you decide when it's the right time for meds. I don't think it's today!

[spacebarsux]

Thanks for the feedback. What is the relevance of the CD8 number and the CD4/CD8 ratio? As I understand it, a high CD8 means there is chronic immune activation (which is obviously not a good thing)? Correct?

Absolute CD8- 1791  (Lab reference range 200-1100)
CD4/CD8 ratio- 0.51 (Lab reference range is 0.7- 3.50)[/b]

[newt]

Assurbanipal has explained the level of accuracy of viral load tests perfectly. Basically, your two viral load numbers are the same.

As for viral load of 100k or more and time for treatment, this is not in current US, UK or European guidelines.

A high CD8 might mean you have a cold.

It is a fair bet that immune activation is a bad thing long term and therefore a fair decision to start treatment to stop this if you judge it the right thing to do. But the exact clinical relevence of immune activation, CD8 figs etc in HIV medicine is unknown and not well studied in terms of outcomes.

You don't want a low CD8 count just to get a "normal" CD4/CD8 ratio. They are important infection-fighting cells.

The important things for me is your CD4 count is normal and you feel well. It's the trend that counts.

- matt

[spacebarsux]

Understood. Thanks.