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Author Topic: What do you think about dividing CD4/VL ?  (Read 1605 times)

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Offline John2038

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What do you think about dividing CD4/VL ?
« on: December 10, 2007, 02:15:18 PM »


1) CD4 count = healthy / infected cells (well, assumption)
So the CD4 is meaningless

2) Whatever the CD4 count is, and whether or no it include the infected cells, what is important is how they can contains the virus.
So it's of course the CD4 AND the VL that are important.

So to see the trend, why not look at the ration: CD4/VL

The more this ratio is high, the better the immune system is doing.

Looking at my counts, the curves look like a 1/x function.
Give a better idea of the trend: in my case, this curve trend to shows that my immune system is stabilizing (ok, based on a very limited samples of data, a limited time period), but much more talkative than comparing 2 bouncing counts (CD4, VL).

What do you think ?

Offline Basquo

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Re: What do you think about dividing CD4/VL ?
« Reply #1 on: December 10, 2007, 03:20:03 PM »
Are you taking into consideration the daily/hourly fluctuation of CD4 counts?  and that "normal" is a very large range? 

So if my viral load is down by half, then my new number is doubled--but is there really a difference between a viral load of 900 and one of 1800?

If you always get your labs drawn at the same time of day, under the exact same circumstances, it might be an indicator to an individual but it couldn't be the same standard for me as it is for you.

Offline John2038

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Re: What do you think about dividing CD4/VL ?
« Reply #2 on: December 10, 2007, 03:35:27 PM »
You might want to draw the curve (CD4/VL), you will see a better trend than 2 bouncing number separately.

If you look at my number, you might think "well, nothing really change".

But the curve say something else: the immune system is getting weaker and stabilizing.

Generally speaking, an increase of the CD4 (out of med) is almost followed by an increase of the VL.
If not, then the immune system is able to control better the virus.
Otherwise, it's the opposite.

This is at the end what this ratio is showing.

Note:
About the numerous blood draw I made, there are many reasons for that, out of the scope of this thread.
But I'll say why: 1) The 2 initial drop sep vs nov was quite big, with low %. 2) Willing to understand how it works (different scenarios, pm/am, sleep time, etc). 3) Planing to be on med next month (identify the NADIR). 4) Don't believe. Try (if safe). 5) I pay the tests ..
Soon, will do a blood draw monthly, then every 3 months.
« Last Edit: December 10, 2007, 04:10:17 PM by John2038 »

Offline Miss Philicia

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Re: What do you think about dividing CD4/VL ?
« Reply #3 on: December 10, 2007, 04:47:38 PM »
I don't get it
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Offline Basquo

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Re: What do you think about dividing CD4/VL ?
« Reply #4 on: December 10, 2007, 06:32:36 PM »
I give up.  Too many words for me. Let us know how it turns out.

Offline dgr20002

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Re: What do you think about dividing CD4/VL ?
« Reply #5 on: December 10, 2007, 06:52:04 PM »
We were talking about percents long before VL tests were available. My understanding is that the percent is the ratio of t-4 to t-8. That's really all I remember as it was many years ago.

Color me confused too.

David

Offline esquimau

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Re: What do you think about dividing CD4/VL ?
« Reply #6 on: December 10, 2007, 11:37:14 PM »
CD4% is considered a much more stable indicator than absolute count because absolute count varies based on time of day, other infections etc.

In the past you may have had CD4/CD8 ratio tossed around, thats sorta old school now and not considered too much anymore.

CD4% is the percentage of CD4 cells to all your other white blood counts (not just CD8).  Ideally that number should be around 33%.  Of course 13% or below is what constitutes AIDS case definition now.  the 13% or below is immunologically akin t0 having <200 CD4 count.
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Offline Coffeechick88

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Re: What do you think about dividing CD4/VL ?
« Reply #7 on: December 11, 2007, 11:18:47 AM »
I don't think it would work.  The absolute CD4 count bounces around a lot--from time of day variations--these counts are always changing along with your other WBC parameters and never stay stable, variations when you are sick, variations when you are on certain meds like prednisone, for eample, and the huge variations on what is normal with people.  I think a panel with absolute CD4, including CD4% along with viral load does just fine.  The CD4 % is much more stable and is a good indicator of how you are doing--so if you go from 500 to 300 and the CD4 % is relatively the same, you will know not to panic at those numbers, for example.
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