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Author Topic: Just got lab work back- question  (Read 1859 times)

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Offline surf18

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Just got lab work back- question
« on: October 13, 2010, 11:19:18 AM »
Viral load undetect
But here is my question
Cd4 was strange
Started at 217 before treatment
Went to :
334 8/3
321 9/9
378 10/1. 262 10/11. Man is this odd to drop like that??
2

Offline jkinatl2

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  • Doo. Dah. Dipp-ity.
Re: Just got lab work back- question
« Reply #1 on: October 13, 2010, 11:47:41 AM »
A CD4 count can fluctuate a hundred points or more. It might well be a blip, or a symptom of an underlying infection, allergies, a cold.

While it is most assuredly NOT odd, it would be wise to pay attention to the next set of labs. This is why CD4 count, by itself, is not the best indicator of your health. Your CD4 percentage, viral load, and general bloodwork all come together to give you a decent snapshot of your overall health. And even then, it is generally measured by trends over time.

*edited for typo
"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline surf18

  • Member
  • Posts: 525
Re: Just got lab work back- question
« Reply #2 on: October 13, 2010, 11:54:54 AM »
Thank you!
My lipid profile is actually better than premeds
% numbers are:
12%- pre med
14%
15%
16%
15%. Now I did don't laugh ha have botox / restyline 3 days before blood wo

N.         No

Offline surf18

  • Member
  • Posts: 525
Re: Just got lab work back- question
« Reply #3 on: October 13, 2010, 11:56:19 AM »
Sorry cont-- got cut off
Anyways could injections interfere with blood work? I asked dr he didn't know for sure.

Offline surf18

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Re: Just got lab work back- question
« Reply #4 on: October 13, 2010, 11:59:23 AM »
Sorry
One more change
I had also added supplement spirulina in last month
I m stopping that
Not sure if that had an adverse effect as well

Offline Assurbanipal

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Re: Just got lab work back- question
« Reply #5 on: October 13, 2010, 12:01:54 PM »
The counts are just a small sample of the blood circulating in your body (thank goodness!) so there can be a lot of random variation in the numbers.  The US treatment guidelines say a change in CD4 count of more than 30% is significant.  So one way to look at your labs would be to put a confidence interval around them of 30%.  That would make your labs look like this:

You started in a range of 157 to 282

Then your labs were in a range of
257 to 434
247 to 417
291 to 491
202 to 341
So, there was a jump when you started treatment, but since then they don't appear too different.  You have one outlier on the high side and one on the low.


Another way to look at them is to graph them. There's a tool on the web site for that, or you can use excel or another spreadsheet.  But, like JK I'd suggest you not be worried about this random variation and instead look to see if a trend develops.

A




5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline surf18

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Re: Just got lab work back- question
« Reply #6 on: November 03, 2010, 04:35:36 PM »
Had test taken again two weeks later , got results back today
cd count is up to 309, thinking that's a nice jump in 2 weeks time

Offline eric48

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Re: Just got lab work back- question
« Reply #7 on: November 03, 2010, 05:44:43 PM »
Surf,

Your CD4% is on the recovery but still in the lower range.

The lower the % the higher the uncertainty on CD4 count (because CD4 count is calculated as the total lymphocytes multiplied by the CD4%) at CD4 262 and CD4% 15 means your total lymphocyte is: 1746

CD4 % is known with an uncertainty that may depend on labs. I suspect mine is +/- 4 % ; in your case the uncertainty is +/- 70 on then CD4 count- so 262 and 309 are , so to speak, the same...

Recovery of CD4 may take longer in some people, but on the long term, a slow recovery does not mean less recovery. Be patient

Cheers!

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

Offline surf18

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Re: Just got lab work back- question
« Reply #8 on: November 03, 2010, 07:19:10 PM »
ok so % is more impt?
this is what is so confusing when i got my orginal diag. i had a low load 16000 but a low cd of 220
you would think a low cd would go with a high load. but none of this makes sense.

Offline Assurbanipal

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  • Taking a forums break, still see PM's
Re: Just got lab work back- question
« Reply #9 on: November 03, 2010, 07:31:48 PM »
The percent is a more stable measurement -- it doesn't flop around as much.  In fact, the CD4 count is derived from it and some other numbers, so it is likely to have less statistical noise. 

But when the numbers get low (lower than yours) the CD4 count is a better predictor of whether you will get sick.
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%

Offline eric48

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  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Just got lab work back- question
« Reply #10 on: November 04, 2010, 04:47:54 PM »
The rule of thumb is:

When CD4 count is less than 500, look at CD4 as an indicator towards disease progression

When CD4 count is over 500, then look at % as an indicator towards disease progression

Dr Galland wrote in one of his answers that at over 500 a CD4% of 15 is 'clinically' equivalent to a CD4 count of 200

In you case Dr, is not looking too much at % because your CD4 count was already low enough to warrant start of meds.

The VL is a amount of virus left over in the blood by each CD4 that has just died. Look at this at their savings account. the amount of gold coin left by the deceased does not matter ... to the deceased.

If a natural disaster falls onto a small rich country (Switzerland) such as a nuke bomb, or falls onto a 'poor' country (such as Swaziland) the amount of coins in their pocket does not make much difference in the magnitude of the (human) disaster.

Cheers!

Eric
« Last Edit: November 04, 2010, 04:50:18 PM by eric48 »
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

Offline surf18

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  • Posts: 525
Re: Just got lab work back- question
« Reply #11 on: November 04, 2010, 05:12:23 PM »
Dr office called me back and told me % on last draw was 19%.
which is the highest I've had since meds even though I've had cd count higher than this last draw.

Offline eric48

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Re: Just got lab work back- question
« Reply #12 on: November 04, 2010, 05:27:30 PM »
means you are on the mend. Congrats! Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

 


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