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Author Topic: Need clarification on importance of cd4 numbers  (Read 1918 times)

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Offline canicken

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  • Casey N
Need clarification on importance of cd4 numbers
« on: June 27, 2013, 07:07:33 PM »
Hi all,

This is my first post.  I'm sure that this topic has been discussed many times, but I just need some clarification on the importance of my cd4 numbers.

Quick background....my exposure was in January/February of this year.  It was with a guy that said he was neg, and honestly it doesn't matter now.....and I believe at the time he thought that he was.....I have to ill will towards him, I am responsible for my own actions.

I went through a really rough seroconversion, I was a fit healthy 175 pounds(gym 6 days a week) and dropped to 158 in 3 weeks, the fatigue was like nothing I've ever felt before.

I First tested poz on April 6, 2013.  My initial labs came back with a VL of 16,000 and a cd4 count of 223.  I started Atripla on April 17, 2013.  on May 17 my VL had dropped to 90, and my cd4 had risen to 350.  My last labs on June 22, 2013 showed a VL of 20, but my cd4 had dropped to 263(18.8%).

My question and concern is with my cd4 dropping.  How concerned should I be?  My Dr said he is only worried about the VL right now, but I'm having a hard time feeling at ease with my cd4's so low.

Am I worrying too much?  Is it normal for cd4's to be that low this early into infection?  I have read about so called "fast progressors" and that has me a little freaked out that I may fall in to that category .

Thanks ---Casey
04/06/2013 Tested Positive
04/08/2013 CD4 326 10.2% VL 16,720
04/18/2013 Started Atripla
05/17/2013 CD4 350 17.5% VL 90
06/22/2013 CD4 263 18.8% VL 20
07/22/2013 CD4 270 19.3% VL Undetectable
09/19/2013 CD4 313 17.4% VL Undetectable
12/22/2013 CD4 374 22.0% VL Undetectable
03/31/2014 CD4 409 21.5% VL Undetectable

Offline Jeff G

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  • How am I doing Beren ?
Re: Need clarification on importance of cd4 numbers
« Reply #1 on: June 27, 2013, 07:18:20 PM »

Hi Casey , welcome to the forums .

I have been on treatment for over 13 years and my cd4 just topped 500 in the last year , it took me that long to get there  .

Your doctor is correct , a undetectable viral load = well controlled HIV and eventual improving cd4 counts . It takes time but adherence and undetectable means you are on the right track .
« Last Edit: June 27, 2013, 07:25:58 PM by Jeff G »

Offline WillyWump

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  • Posts: 7,162
  • your ramblings bore Yamaguchi Kitteh
Re: Need clarification on importance of cd4 numbers
« Reply #2 on: June 27, 2013, 08:31:01 PM »
I wouldn't be too overly concerned with your slight drop to 263 (easy for me to say I know), but your CD4's and your VL were kind of fighting it out during this time. Now that you are technically UD your CD4's will have a chance to stabilize and rebound. They may rebound quickly, or they may take some time. Everyone is different.

Just stay adherent and you will do just fine.

BTW, when I started meds 5 years ago my CD4 was 175ish and VL was 186k. Today my CD4's are up over 1000. ;) Also keep in mind that sometimes the CD4's will bounce around over the years and will not always have an upward trajectory.

-Will
« Last Edit: June 27, 2013, 08:34:29 PM by WillyWump »
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: Need clarification on importance of cd4 numbers
« Reply #3 on: June 28, 2013, 06:24:50 AM »
Hi Casey, welcome to the forums.

It is quite possible that your CD4 counts pre-infection were on the lower side of "normal". A "normal" (non-hiv poz) CD4 count is anywhere from 500 - 1500.

If your pre-infection counts were in the 500-600 range, then your counts aren't really that low. Unfortunately CD4 counts are rarely ever done outside the context of an hiv infection, so you'll probably never know.

Don't worry about being a fast progressor. Your VL was actually low for such a new infection; in fact that's what made me think your pre-infection CD4s were possibly on the low side of "normal".

Something you should know - CD4s can fluctuate by as much as 100 during the course of a single day. They tend to be higher later in the day and lower first thing in the morning.

This fluctuation is why the CD4% is a good number to look at as it remains more stable.

You can read about CD4s and CD4% in the CD4 Test lesson available elsewhere on this site. You may also be interested in reading through some of the other Lessons available. You don't have to learn everything all at once, and feel free to come back into the forums with any questions that may arise while reading the Lessons.

You can also read about the meds you're on in the Treatments pages.

Hang in there, keep taking your meds and you'll be just fine.

Ann
Condoms are a girl's best friend

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"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline canicken

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  • Posts: 5
  • Casey N
Re: Need clarification on importance of cd4 numbers
« Reply #4 on: June 28, 2013, 12:34:33 PM »
Thanks for the reply's.

I know I just have to be patient  with the process of finding out how my body's immune system will eventually adjust to both the virus and the medication.....but patience is not my best virtue...haha

I have read as much as I can to be informed, and I am less alarmed at the absolute number now than what I was initially......although having my cd4% at 18% still makes me uneasy and impatient to see that number improve.

Thanks,

Casey
04/06/2013 Tested Positive
04/08/2013 CD4 326 10.2% VL 16,720
04/18/2013 Started Atripla
05/17/2013 CD4 350 17.5% VL 90
06/22/2013 CD4 263 18.8% VL 20
07/22/2013 CD4 270 19.3% VL Undetectable
09/19/2013 CD4 313 17.4% VL Undetectable
12/22/2013 CD4 374 22.0% VL Undetectable
03/31/2014 CD4 409 21.5% VL Undetectable

Offline DrewEm

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Re: Need clarification on importance of cd4 numbers
« Reply #5 on: June 30, 2013, 03:48:50 AM »
Welcome Casey,
   As others have said CD4 count is an odd thing. One thing you want to watch is the per centage of virus to CD4. As my ID doc explained not everyone has the same CD4 strength. I was diagnosed in April 2010 with a CD4 below 10 (made me actually an AIDS patient) but I never had an issue with the flu or common colds. I am up to 28% now and healthy - the ID doc is happy with my progress.

Offline Ann

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    • Num is sum qui mentiar tibi?
Re: Need clarification on importance of cd4 numbers
« Reply #6 on: June 30, 2013, 07:55:58 AM »

One thing you want to watch is the per centage of virus to CD4. As my ID doc explained not everyone has the same CD4 strength. I was diagnosed in April 2010 with a CD4 below 10 (made me actually an AIDS patient) but I never had an issue with the flu or common colds. I am up to 28% now and healthy - the ID doc is happy with my progress.

The percentage that we track is NOT "the per centage of virus to CD4".

Quote


If you look at your lab report, you will also see something called your CD4+ percentage (%). This is an important number for you and your doctor to know. In healthy adults, the number of CD4 cells make up between 32% and 68% of the total number of lymphocytes?a large group of white blood cells that include CD4 cells, CD8 cells (see below), and B-cells. In fact, the lab uses the CD4 percentage to determine the number of CD4 cells in a sample of blood.

read more here

Drew, I think you misunderstood your doctor.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline lincoln6echo

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  • Posts: 109
Re: Need clarification on importance of cd4 numbers
« Reply #7 on: July 09, 2013, 12:16:43 AM »
Hi canicken
When I was first infected/newly diagnosed last summer and got my first labs, I was freaked out too.

My VL just over a month after infection was just over 9 million and my CD4 was 364 or something. My VL really had my loosing sleep and I was very sick at the time. I think I was diagnosed during seroconversion.

That was my lowest recorded CD4.
My latest labs two weeks ago show Cd4 1080 and VL at 61, my "best" numbers yet. So it's basically taken a year, but everyone is different.

Good luck and take some deep breaths, you learn to be patient going through this.

lincoln.

Offline canicken

  • Member
  • Posts: 5
  • Casey N
Re: Need clarification on importance of cd4 numbers
« Reply #8 on: July 13, 2013, 11:07:54 AM »
Thanks for all the great advice.

I have my next round of labs in a couple of days, so I am anxious to see how my numbers are improving.

If my absolute cd4 & my cd4%(263 at 18%) shows some improvement I'll post it here.  Physically I am finally starting to feel somewhat normal.

 I definitely have some lingering fatigue issues but those are improving also.  I've found that I cannot drink the way I used to, which usually was just a glass of wine in the evenings or a few drinks with friends on weekends.  I also have noticed that I have to be very consistent with my diet and time that I take my Atripla.  Taking it any later than 8:30pm, or having any alcohol really puts me in a fog the next morning.

 I have finally gotten back on track with the gym.....I never really stopped going, but for the last few months I was definitely just going through the motions......and in reality I never gave my body a real rest either.....working out has always been my best stress reliever, and I think it may have worked against me a little bit while going though one of the biggest stresses of my life.  I have a tendency to push myself to exhaustion far too often (went to the gym, then to work, then to the ER all in one day...haha).  When I went through seroconversion I had never been so sick in my entire life.  I  went from an already lean 175 pounds(working out 6 days a week) down to 158 in about 3 weeks, it felt like my body was eating itself.  I'm gaining back a lot of the muscle I had lost, but I still have a ways to go.

Ha, sorry for getting a little off subject.....it's just how my body has struggled, the fatigue and my low cd4's have been the hardest parts of becoming positive.....and I do see that maybe I'm somewhat responsible :o for not allowing my body adequate rest......I think that its the idle time that is the hardest, I've not stopped to really consider what has happened....I know that will come in time....

"When the student is ready the Teacher will appear".... ;)


thanks again,

casey
04/06/2013 Tested Positive
04/08/2013 CD4 326 10.2% VL 16,720
04/18/2013 Started Atripla
05/17/2013 CD4 350 17.5% VL 90
06/22/2013 CD4 263 18.8% VL 20
07/22/2013 CD4 270 19.3% VL Undetectable
09/19/2013 CD4 313 17.4% VL Undetectable
12/22/2013 CD4 374 22.0% VL Undetectable
03/31/2014 CD4 409 21.5% VL Undetectable

 


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