Decreasing cd4 count but undetectable

[windupwindbird]

Hi, I was diagnosed with HIV in January and had an initial cd4 count of 282 in a treatment hub then the same month I transferred to a private hospital so they requested another cd4 count. My viral load wasn’t checked in both. My cd4 count rose to 437. Soon after I started treatment. After three months, mid-May. I had my followup lab tests. My cd4 dropped to 343 but my viral load was undetectable. After a month - that’s June - I decided to have my cd4 count checked again because I was experiencing some symptoms like night sweats and dry mouth.  My cd4 count continued to drop. Now 273. But this was in another clinic, different from the first two.

Why is my cd4 dropping yet I’m undetectable?

[Jim Allen]

Hiya

You only just started treatment and, was UD by May.

Your CD4 count went up slightly & than settled back, it's not unusual, CD4 counts can and, do vary day to day between measurements my own have shifted up or down 300's

Keeping in mind that your CD4 is not a measurement of health or changed by HIV meds and, it can take time to generally settle into treatment and, for the body that no longer is having to fight a loosing battel to "heal" so to speak, ups and downs in lab work is common.

What was the % like?  Long term it's best not to focus on this or give it more value than it deserves

[windupwindbird]

Hi Jim,

The percentage was from 22% - 27% - 22%. Not stable.

[Jim Allen]

Hiya

That's grand, as though it just peaked a little bit around the time of starting to reduce the VL and, then leveled back out.

ups and downs in lab work is common, particularly CD4 and it's only a few snap shot moments within the first year, so early on. To be honest some people's CD4 counts never shoot up high again and, are perfectly fine, others see it go up within the first years of suppressing HIV.

Give your body time, try not to focus on CD4

[MarkintheDark]

Adding to @JimAllen's perspective, you mentioned a different clinic took the latest draw.  In my experience, different processing labs can produce slightly different results.  In the course of switching protocols a couple years ago, samples drawn simultaneously were submitted to two different labs and came back with different CD4 absolutes.  I've had similar discrepancies between the protocol and my regular clinic, as well.

While the absolutes are perhaps a convenient metric, for all the reasons stated they're often given too much weight, imo.  If anything, I prefer to go with the percentage.  So, too, I've found that scheduling the draw the same time of day each time - first thing in the morning for me - has yielded more consistent results.

That being said, it perfectly normal that for a while that you'll be laser focused on numbers.  Eventually the ups and downs won't matter as much to you.  As already mentioned, the most important thing is that you're consistent with your meds and remain UD.  I'm encouraged you responded so quickly to treatment.

Sometimes, to simplify things, simply ask, "How do I feel?"  You mentioned the sweats and dry mouth.  Though I'm by no means a physician, it doesn't sound like a cause for alarm.  Personally, I've gone through that off and on the past 26 years.  If the symptoms persist, however, it's probably a good idea to speak to your PCP.

[windupwindbird]

Thank you guys for the encouraging words. I understand that cd4 fluctuates, but the cd4% is much more stable. What to could be the reason for this? Is it just because I did it in a different clinic? My regular clinic releases results at least 3 days and this one just does it within the day. Could it be just the machines?

[Jim Allen]

Overall Jan till now there is no real difference in your % if you ask me, a slight peak around the time you started to suppress the virus, odds are the next results will be slightly different again. As long as it's above 200 or 14%  there is no point focusing or worrying about it, as it's simply not within your control.   

So yeah, variance happens, the Lab (The machine), time of day, normal ups & downs, the fact you just started to suppress the VL, it's within the first years, the body is still healing...

% is perhaps somewhat more stable viewed over a trend compared to count but this does not mean that variance between measurements does not happen.

[Jim Allen]

Try not to get overly focused on CD4's. It's not that important at this stage.

Hope you feel better soon and, if not check with GP.

Jim

[windupwindbird]

Thank you Jim.