cd4 "state of EQUILIBIRIUM"? Numbers no longer moving in 2009

[BlkRedBonenla]

During my years as an HIV dissident, I questioned the cd4 hypothesis because no baseline had been established overall or for the individual. It is commonly discussed among HIV dissenters that cd4 varies in coach potatoes vs. marathon runners, for example.

Such arguements were dismissed by the conventional Western medical wisdom.

Well, 2009 has seen no more rise in my cd4, nothing statistically appreciable. I seem to hover in the mid 400's [see signature]. When I questioned my doctor about this, she said what the dissenters have been saying: that cd4 reaches different EQUILIBRIUMS for different people, that the body will determine how many T-cells it needs.

After hearing that 1000 is "nornal" I am pretty astounded to hear this.

Can anyone corroborate? Should I be bummed or indifferent?

Taking a page from the marathon-runner lower cd4, I am a competitive, open-water swimmer, 8-10 miles /week now in the ocean. Not a purist vegetarian, may eat chicken or fish once a month. No smoking. No alcohol ... just puzzled.

Thanks,
Lowell

[Miss Philicia]

The lower your nadir for your cd4's (i.e. 20) the less likely it is for your cd4's to go up as high as someone who began treatment at, say, 400 cd4s.  That said, this is just based on statistics I assume and obviously there will be people that are able to achieve higher results, while some may have lower.  But yes, it's also true that one doesn't know what they're cd4 baseline was pre-infection but assuredly one would think even a dissenter knows it's not 200.

Actually I'd say that all things considered that for someone who had 20 t-cells just 2 years ago you're doing fairly well.  It's also not unheard of for someone to reach a plateau in cd4s for several years, then start having them increase again after that period.  That's what happened to me, and I'm over 1,000 now but then I've also stuck with taking medication for 16 years.  Maybe you should readjust your preconceptions.  You're undetectable, so your medication is working, and your cd4 counts are out of the general danger zone for OI's -- what's the issue?

[Ann]

Hi Lowell,

Actually, "normal" CD4s are usually considered to be between  500 and 1000. So, you're not that far off, really. I agree with Miss P. You're doing great for someone who started out with only 20 of the darn things. Any idea what your percentage is like?

I'm glad you came back from the dark side before it was too late. May the CD4s be with you!

Ann

[Inchlingblue]

Miss P and Ann make, as usual, very good points.

One way to see what "normal" is would be to look at one's lab results from blood work. My last labs I had 392 absolute CD4s (this was before I started meds) so it was not highlighted, the way they highlight readings that are out of range, because they consider normal range to be 365 - 2087!

Of course my % and my CD4/CD8 ratio were not in the normal range.

So if someone who does not have HIV gets a reading of, say, 370, it would not be considered out of the ordinary from the lab I get tested. Of course, if that person does not have HIV then their % and their CD4/CD8 ratio should also be normal, unlike mine.

I think it makes sense that not everyone would be at the same level and that individual's CD4 equilibrium would vary, maybe based on one's pre-HIV baseline, which pretty much nobody ever knows. How expensive would that be, to have the general population get regular CD4 readings to see what the baseline is in case they later on get HIV? Not gonna happen.

Maybe individuals whose CD4s drop to below 200 soon after infection (such as Madbrain's bf) had lower baseline numbers to begin with?
 

[madbrain]

After hearing that 1000 is "nornal" I am pretty astounded to hear this.

Where did you hear this ?

From http://www.aidsmeds.com/articles/TCellTest_4727.shtml :

The normal CD4 count is somewhere between 500 and 1500 cells per cubic millimeter of blood. [/I]

Can anyone corroborate? Should I be bummed or indifferent?

Taking a page from the marathon-runner lower cd4, I am a competitive, open-water swimmer, 8-10 miles /week now in the ocean. Not a purist vegetarian, may eat chicken or fish once a month. No smoking. No alcohol ... just puzzled.

At 442 you are slightly below the normal range which is 500. But not all that far off from it. I think my Kaiser labs say the low end of normal is 475 or so. It really depends on individuals. It's hard to say what's right for you unless you had a CD4 count taken before you were poz. How is your CD4% evolving ?

FYI my bf's CD4 cannot seem to go beyond 400 . He started Atripla on 3/07 just like you. His worst numbers before were CD4 230, VL 35K. He doesn't drink a drop of alcohol either, nor smoke. He also used to be a swimmer, though he hasn't done much of that in recent years.

[elf]

Normal range is something like 400-1400 for men,  600-1600 for women, and 800-1800 for children.

factors leading to higher CD4 count in healthy individuals
1) female sex
2) being a smoker
3) CD4 measured in the afternoon, evening, or during night
4) CD4 being measured after sleepless night



My CD4 are jumpy, going up and down all the time (I've been on med's for 11 months):

353---> (meds)  ---> 690 --->910--->1109-->900

I don't like this wavy trend, I expect my new number to be around 600 (during my next check, in November)

[elf]

Maybe individuals whose CD4s drop to below 200 soon after infection (such as Madbrain's bf) had lower baseline numbers to begin with?
 

I've read that lowish normal CD4 values are common in Central Africa which makes people living there more prone to rapid progression of HIV disease.

[madbrain]

I've read that lowish normal CD4 values are common in Central Africa which makes people living there more prone to rapid progression of HIV disease.

Could be - it wouldn't be very surprising in malnourished populations to have low CD4 baselines. In the case of my bf I still can't explain it. He is asian, FYI, vietnamese. But not malnourished by any means.

[BlkRedBonenla]

Thanks for so many wonderful, insightful points ....

I've come along way for sure - as Miss Philicia asks: what's the issue??

I will have to follow Madbrain's advice and get the cd4 PERCENTAGE, which I never thought to ask about (my questions are always about cd4, VL, and my LIVER #s)

needlessly worrying about the half-empty cup!

[Lido]

Hi My Family (ALL in this field is my family)
My question is why is my Cd4 dropping. It has fallen from 720 to 400 from last year. When i asked my doctor she said that the Cd 4 doesnt matter so much. What matters is the virus. My virus has been below 50. I have been poz since 1996, currently on Reyataz, Truvada, Norvir.

[Inchlingblue]

Hi My Family (ALL in this field is my family)
My question is why is my Cd4 dropping. It has fallen from 720 to 400 from last year. When i asked my doctor she said that the Cd 4 doesnt matter so much. What matters is the virus. My virus has been below 50. I have been poz since 1996, currently on Reyataz, Truvada, Norvir.

It's possible they could drop for many reasons (slight infection, immunization, lots of stress in your life, not enough sleep, etc) so you should also look at the CD4%, which tends to be a more stable number.