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Author Topic: CD4 Count: Inconsistent Lab Results. How do I interpret it?  (Read 1423 times)

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Offline iHope

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Greetings,

I am newly infected patient with HIV.

on April 11th, I have received the news from my doctor.

On 04/14/14 my blood was taken for viral load and CD4 count at a hospital. The result shows as follows:

Abs.CD4 Helper              686/uL 
CD4 Pos. Lymph %         34.3%
Viral Load: 19550

On 04/21/14 I had another lap test in a different hospital for viral load and CD4 count. And their lab shows the following results:

CD4 ABSOLUTE            1133  /uL
CD4 POS. LYMPH %       47.2 %
Viral Load: 10100

On 04/14/14 I started taking ARV Medications.

My question is: How come my CD4 count jumped from 686 ( 34.3%) to 1133 (47.2%) in a week? Is it normal?
Also, is it normal for viral load to drop so sharply in one week from 19550 to 10100?

How should I interpret these lab results?


Offline wolfter

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #1 on: April 24, 2014, 01:55:51 PM »
I need to save the graph that shows the progression of HIV.  It sums it up better than I can explain it, but I'll try my best.

With a new HIV infection, your body will naturally respond and fight like hell to kill the invaders.  You'll see a temporary improvement, but ultimately, your immune system isn't as strong as the virus and your troops start dying at a steady pace.  Once you're down to a few platoons, all your other enemies have the ability to step in destroy you.

wolfie

Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline zach

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #2 on: April 24, 2014, 02:02:19 PM »
cd4 goes up and down sometimes 100s in a single day... each individual lad result is only a snapshot, fear not any change + or -. look at your starting point, go from there, and look at the overall trend.

you started in a great place, stands to reason you're numbers will respond strongly to the introduction of meds. i view that as a great thing. over time, things will settle to a more balanced baseline. you'll go UD, and coast man

wolf is right about the graph, hopefully someone will come along with it. is it in one of the lessons? it perfectly explains and calms.

and wolf. i fkn love your division/company/platoon/squad analogy. i'm stealing that one buddy.
« Last Edit: April 24, 2014, 02:09:08 PM by zach »

Offline mecch

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #3 on: April 24, 2014, 02:06:05 PM »
You two missed the obvious explanation.

iHOPEs first labs were the same day treatment started.
Ihopes second labs were ONE WEEK INTO TREATMENT.
So the meds knocked down the VL and the CD4 went up.  Its whats supposed to happen.


Looks like you will be in good shape very soon iHOPE and that you will have a 1000+ CD4 probably.  Great news.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline wolfter

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #4 on: April 24, 2014, 02:07:38 PM »


and wolf. i fkn love your division/company/platoon/squad analogy. i'm stealing that one buddy.

Thanks, sometimes gold is found in a coal mine.  :)
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline wolfter

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #5 on: April 24, 2014, 02:12:38 PM »
You two missed the obvious explanation.

iHOPEs first labs were the same day treatment started.
Ihopes second labs were ONE WEEK INTO TREATMENT.
So the meds knocked down the VL and the CD4 went up.  Its whats supposed to happen.


Looks like you will be in good shape very soon iHOPE and that you will have a 1000+ CD4 probably.  Great news.

You know, I didn't miss anything.  I tried to simplify my response for a new member who has a recent diagnosis.  You could have added your input without demeaning or negating our responses. 

Sorry to OP, I could have just ignored and moved on.  ;)

wolfie
Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline mecch

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #6 on: April 24, 2014, 04:01:27 PM »
Im not demeaning you, at least not my intention. Sorry

The referred to graph is meaningless to interpret this situation. Because the OP is already on HAART.  The graph is about the course of untreated HIV infection. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mecch

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #7 on: April 24, 2014, 04:03:27 PM »
I need to save the graph that shows the progression of HIV.  It sums it up better than I can explain it, but I'll try my best.

With a new HIV infection, your body will naturally respond and fight like hell to kill the invaders.  You'll see a temporary improvement, but ultimately, your immune system isn't as strong as the virus and your troops start dying at a steady pace.  Once you're down to a few platoons, all your other enemies have the ability to step in destroy you.

wolfie

Your post clearly is about what happens when someone is untreated.  Maybe its about that use of "you".  Anyway I was merely pointing out the oversight. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline iHope

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #8 on: April 24, 2014, 05:06:12 PM »
So I guess I should continue monitoring my Viral Load and how CD4 acting up over the period of time as a trend.

What I am surprised is that the CD4 count almost doubled in one week.

Offline leatherman

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #9 on: April 24, 2014, 05:22:59 PM »
So I guess I should continue monitoring my Viral Load and how CD4 acting up over the period of time as a trend.
individual tests don't mean much. It's always about the Trend over at least 3 tests in 3 months or more.

don't get hung up on the numbers. Since you're on meds, all you need to care about is getting to Undetectable.  ;)


ps here's the graph Wolfie
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline iHope

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Newly diagnosed. Please help me to understand my test results.
« Reply #10 on: May 01, 2014, 07:10:40 PM »
Greetings and thank you for reading my post.

I am newly diagnosed and here are my test results:

08 April: First ever Viral Load test result was: 19550

11 April: Started my ARV treatment

14 April: Viral Load is 10190 and CD4 is 686 (34.3%)

21 April: Viral load is 60 and CD4 is 1133 (47.2%)

My question is: How realistic is is that my Viral Load went down from 19550 to 60  , and my CD4 increased from 686 (34.3%) to 1133 (47.2%) after just 10 days of taking ARV.

Is there general/average pattern how VL decreases and time it takes for cd4 to increase? My cd4 increased almost double in just ten days.


Offline Joe K

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #11 on: May 01, 2014, 08:30:28 PM »
iHope,

I've merged your new thread into your original thread, dealing with the same subject.  It helps us, to help you, when you keep everything in one thread when dealing with the same subject.  Also the Off Topic Forum is for every subject, EXCEPT for HIV.

Thank you for your cooperation.

Joe
« Last Edit: May 01, 2014, 09:19:31 PM by Joe K »

Offline AusShep

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Re: Newly diagnosed. Please help me to understand my test results.
« Reply #12 on: May 01, 2014, 09:14:41 PM »
...
My question is: How realistic is is that my Viral Load went down from 19550 to 60  , and my CD4 increased from 686 (34.3%) to 1133 (47.2%) after just 10 days of taking ARV.

Is there general/average pattern how VL decreases and time it takes for cd4 to increase? My cd4 increased almost double in just ten days.

VL drop is realistic, you'll probably be undetectable in less than a month, which is good.

Also, people have already discussed the CD4 numbers.  I'd bet with Meech that you'll be in great shape with stable CD4s over 1000.  You'll need to hold on and check your trend over the next year while staying UD.

Offline wolfter

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #13 on: May 02, 2014, 02:23:41 AM »
I thought I was addressing the initial perceived rebound in the immune response.  So as not to detract from the OP's questions, I'll once again admit that I know very little about this virus.

Complacency is the enemy.  ;)  Challenge yourself daily for maximum  return on investment.

Offline eric48

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #14 on: May 02, 2014, 05:26:17 AM »
CD4 populations can grow by 2 means:
- new borns from bone marrow mature in the thymus and join the existing pool
OR
- simply clone themselves

Which of these 2 processes is fastest and less energy consuming ?

Which of these 2 processes is likely to be contributing the most to your CD4 increase ?

I have had a sharp increase (700 to 1400) between 2 readings. My sampling frequency is usually once every 2 months (and I had skipped one) so my 2 readings were 4 months appart, si it was 700 to 1400 in 4 months or less

This is not usual, but keep in mind that 'historical' patients typically waited quite long before iniating meds

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline mecch

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Re: Newly diagnosed. Please help me to understand my test results.
« Reply #15 on: May 02, 2014, 05:33:38 AM »
Is there general/average pattern how VL decreases and time it takes for cd4 to increase? My cd4 increased almost double in just ten days.

There is a known pattern for VL decrease on HAART initiation. My doc explained it to me when I went on meds but that was years ago so I don't remember it. Someone here might known and give you a link.  It has to do with "log" reductions over the time that is an HIV replication cycle (and I don't know what that time is, either  :o )

Since this is the second time you posted the same question, and the answer is you are in great shape the first time, I am wondering how you are doing with the stress of it all.   Are you worrying all the time about your prognosis? Or are you able to get on with other things.  Its pretty common to experience quite a lot of ruminative thinking with the shock of diagnosis and treatment...   You should be able to find an answer to your questions - to help feel more secure.  One way is to see if your doc is the kind of doc willing to answer questions.  (Hopefully!) Then you write down your questions and each time you see the doc go down the list, within the docs time limit.  Sometimes hearing from the doctors mouth helps a lot.  Also, yeah, asking here and being shown the reference for the answer.


“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Hellraiser

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #16 on: May 02, 2014, 09:30:42 AM »
No one has addressed that this guy has gotten this many tests in the span of less than a month's time?

Ihope, Unfortunately to make any reasonable commentary on the trending of your lab reports we would need a longer timespan.  One month is barely indicative of any overall trend.  I would not worry so much about the numbers as long as you feel good and they aren't catastrophic.  Most of us monitor our numbers once every 3, 4, or 6 months.

Offline Ann

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #17 on: May 02, 2014, 10:58:16 AM »

No one has addressed that this guy has gotten this many tests in the span of less than a month's time?


It's because he was only diagnosed on April 11th. He started meds on the 14th and had another blood draw a week later on the 21st. Not at all unusual. He'll probably have yet another blood draw around a month/six weeks after starting meds too.




iHope, going by your numbers, it's quite possible that you were only very recently infected. From what I've seen over the years, the sooner after initial infection one starts meds, the faster the VL drops and the CD4s go up.

Everything is going in the right direction for you and that's a good thing.

Ann
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 leatherman

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #18 on: May 02, 2014, 12:02:21 PM »
It's because he was only diagnosed on April 11th. He started meds on the 14th and had another blood draw a week later on the 21st.
11 April: Started my ARV treatment

14 April: Viral Load is 10190 and CD4 is 686 (34.3%)

21 April: Viral load is 60 and CD4 is 1133 (47.2%)
I think you misread just a bit. actually ihope posted that he had a VL done only three days after starting meds, and then had another VL done just 10 days after starting meds. That's really a lot of testing in a very short time.

that's two tests in 7 days. Then if you count the VL from the diagnosis bloodwork, it totals 3 VL tests in 13 days. that's a lot of money and resources spent on someone who is not very ill at all. I don't mean that in a rude way but its not like ihope was down to 5 cd4s and in the hospital with an OI needing to be monitored once a week. LOL (heck! I really have been that sick and I was never monitored that frequently :) )
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Ann

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #19 on: May 02, 2014, 01:14:30 PM »
I think you misread just a bit. actually ihope posted that he had a VL done only three days after starting meds, and then had another VL done just 10 days after starting meds. That's really a lot of testing in a very short time.

that's two tests in 7 days. Then if you count the VL from the diagnosis bloodwork, it totals 3 VL tests in 13 days. that's a lot of money and resources spent on someone who is not very ill at all. I don't mean that in a rude way but its not like ihope was down to 5 cd4s and in the hospital with an OI needing to be monitored once a week. LOL (heck! I really have been that sick and I was never monitored that frequently :) )

I was going by his first post, quoted below. Also, his second set of labs was done at a different hospital, presumably by a different doctor who probably wanted new labs for his own records.

Not unusual at all, all things considered.

Greetings,

I am newly infected patient with HIV.

on April 11th, I have received the news from my doctor.

On 04/14/14 my blood was taken for viral load and CD4 count at a hospital. The result shows as follows:

Abs.CD4 Helper              686/uL 
CD4 Pos. Lymph %         34.3%
Viral Load: 19550

On 04/21/14 I had another lap test in a different hospital for viral load and CD4 count. And their lab shows the following results:

CD4 ABSOLUTE            1133  /uL
CD4 POS. LYMPH %       47.2 %
Viral Load: 10100

On 04/14/14 I started taking ARV Medications.

My question is: How come my CD4 count jumped from 686 ( 34.3%) to 1133 (47.2%) in a week? Is it normal?
Also, is it normal for viral load to drop so sharply in one week from 19550 to 10100?


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 mecch

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #20 on: May 02, 2014, 05:07:30 PM »
I had lots of tests at the beginning as I was identified in seroconversion. 

In a nutshell, iHope is doing great.  The next thing - let iHope speak more about the diagnosis and why the message may, or may not, have sunk in.

At the level of blood, everything is going fantastically.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Ann

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #21 on: May 03, 2014, 06:50:49 AM »
I had lots of tests at the beginning as I was identified in seroconversion. 


In my first year post-diagnosis, I had ten sets of labs done with one instance of them being only one day apart, and another instance at two weeks apart. Like I said above, it's not unusual to have lots of blood draws in the initial months following diagnosis. The more, the merrier. ;)
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 Hellraiser

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #22 on: May 03, 2014, 08:12:17 AM »
It's because he was only diagnosed on April 11th. He started meds on the 14th and had another blood draw a week later on the 21st. Not at all unusual. He'll probably have yet another blood draw around a month/six weeks after starting meds too.

Ann

Yeah I know it's because he's newly diagnosed but within that short a time frame there's really not much information for us to extrapolate is the point I was attempting to make.

Offline iHope

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Re: CD4 Count: Inconsistent Lab Results. How do I interpret it?
« Reply #23 on: May 06, 2014, 10:23:30 PM »
Hey guys, thank you all for your inputs.

Yes, it seems that I had few blood work done in very short spam of time. This is because, my doctor took another sample for the confirmation. My doctor referred me to affiliated clinic, but I had to wait 5 days for an appointment, so I went to a different STD clinic and got blood work done there also.

I guess I am a bit over that panic mode, and more I read the materials on HIV, more I feel control over my condition.

I have an appointment with a doctor for a follow up on the 27th.

Thank you



 


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