Wow, results gone out of control- worried

[ScaredNinja]

Hello, I recently got my new blood work done and they look like this
1769 cd4
<20 viral load
%cd4 55.3%

My normal cd4 count is normally around 900 to 1200. Why did it jump so high? I was sick week prior but it was a small cold but it was not freakishly bad or anything. Anyone experience a jump like this before?

[mecch]

I can't explain it. Listen if you dont want all 'em I'll take 500, please. 

[Wade]

Well Hell...I could use a couple hundred if you're passing them out 🤔

[ScaredNinja]

So I should not be worried? It's just that online it showing up as a red meaning abnormal. So searching online it could be a bad thing.

[leatherman]

So I should not be worried? It's just that online it showing up as a red meaning abnormal. So searching online it could be a bad thing.

the general definition of "normal" cd4s is 500-1200; however 400-2000 is just as "normal"

if you had less than 200 cd4s you should be concerned; however, if you're undetectable and your cd4 is >200, you have no reason to worry about your cd4 count regardless of what it is.

Actually according to the current HRSA HAB guidelines (from 2015), with numbers like yours, you never to have to have another cd4 count again. Yeah! You save money on your health care costs, and you save yourself needless worrying.

the current guidelines are:
After 2 years of ART, VL consistently suppressed and CD4 consistently 300-500:
Time between viral load test can extend to every 6 months for patients with consistent viral suppression for >=2 years.
With the cd4 test done every 12 months

After 2 years of ART, VL consistently suppressed and CD4 consistently >500 cells/mm3:
the CD4 test is Optional

https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv-guidelines/458/plasma-hiv-1-rna--viral-load--and-cd4-count-monitoring
"Table 4. Recommendations on the Indications and Frequency of Viral Load and CD4 Count Monitoring"
http://hiv.ucsf.edu/docs/hiv_monitoring_guideline.pdf
"Table. Summary of HIV-specific routine laboratory monitoring" (pg 5)

These guideline changes reflect the science of monitoring patients (who are and are not virally suppressed) to decrease the lab visit burden to patients and the associated costs of those tests (lab work and doctor appts). While that's a win-win for patients (less trips to the doc, less jabs with a needle, and less money spent to health care), in cases where these services are covered through a state's ADAP or Medicaid program, these cost savings will help states to provide more services for even more people.

Of course, any clinical changes or med changes puts a patient at a different testing level with has more frequent testing based on the situation until patients are once again virally suppressed for the recommended length of time.

[bocker3]

So I should not be worried? It's just that online it showing up as a red meaning abnormal. So searching online it could be a bad thing.

Yes -- it is generally not a good thing to go looking around online, as it is human nature to focus on the most horrible of things listed.
Remember a single lab result that looks "out of the ordinary" for you is rarely anything to worry about -- HOWEVER, there is a reason that lab tests are ordered by and results sent to a doctor.  It is because he/she is able to look at them, without emotion, and in a way that takes in your entire situation. 
If you have a lab result that is "concerning" - he/she will do the appropriate follow up.

Now -- I'm not saying that you should silently wait for them to react.  You should be a partner in your care, so if you DO have concerns, talk with your doctor. 

You can use this site for support and to hear stories (similar or different) but you need to work with your doctor for medical advice on your situation.  We are all unique and may need to react differently to similar situations.

Mike

[Mightysure]

Well the internet is a good place with lots of great info, but there's also a lot of dated, garbage and varying opinions out there too. You're abnormal yes, but abnormal doesn't necessarily mean bad.
What your labs show is a snapshot of your cd4 at the time blood was drawn. Your immune system is working well. As you see that there are plenty of ppl who would take a few hundred off your hands. Lmao.
If your doctor isn't concerned, I wouldn't be.  Your cd4 could be cut by 2/3 and you'd still be in good shape.

[harleymc]

'Out of control' implies that the aim of HIV treatment is to keep cd4 counts low.
Is there a memo i missed from my HIV specialist?

[bocker3]

'Out of control' implies that the aim of HIV treatment is to keep cd4 counts low.
Is there a memo i missed from my HIV specialist?

Well, first -- the aim of HIV treatment is to kill the virus, it has nothing, directly, to do with CD4 counts.

Second -- the OP is concerned because their CD4 is outside the upper limit of the reference range.  So, while I assume you are trying to reassure, you are missing the mark with your comments, as this ONE RESULT is, in fact, outside the reference range. 

When a lab test has a lower and upper end reference range, it is because there MAY be issues associated with either low or high levels.  However, as many have stated, the OP should be talking with their doctor around this -- generally, a single out of range result is not anything to worry about, but the doctor is the best one to talk with because he/she can look at the entire medical picture to assess what, if anything, should be done next.

Mike