low cd4, high %

[wtfimpoz]

What could it mean?  Like, say, 420 and 38%?   

[littleprince]

420 isn't low

[wtfimpoz]

I meant relative to the percentage. 

[tednlou2]

I don't know.  I have the opposite issue.  I have a good CD4 but % dropping.  Most treatment guidelines talk mainly about the CD4 as to when to start meds and rarely mention percentage.  However, docs/experts say the % is a better indicator of immune health.  So, it confuses me which to give more weight.   

[eric48]

Above CD4 500, cd4% is a better indicator of decease progression.

Your defense army is stuck at WWI front. there are enough soldiers (>500) but if % lowers it means that level of rotation is high ... The problem is that on that front, there is a rebellion, CD8s are killing CD4s, which are soon replaced, but... A low percentage means that there are less CD4 (loyalists) than CD8 (killers)

As a result...

Soldiers are younger, less experienced, the number of officers has decreased. More and more inexperienced recruits are coming to the front, so , yes, on a snapshoot image, there seem to be enough soldiers to protect against enemies (infections)... they may be able to reply to one or 2 attacks, but, no more... hence, disease progression.

%38 is NOT low. 30 is the minimum for a reference range

% 20 is not normal and not life threatening. In terms of disease progression there is a plateau from 15 to 25 where differences in % are not statistically nor clinically very relevant , BUT, in untreated patients, once the % goes lower than 15% , then disease progression goes much faster (accelerates) which is why %14 is (or was) considered as a criteria for AIDS.

wtfimpoz's army is not numerous but robust and well trained (like the Swiss army, a country that has never been invaded). It is also a costly army (meds...)
tednlou2 's army is numerous but less robust (like Saddam's former army): good enough against a minor enemy (Kuwait) but no match against a major intruder (US) , on the other hand, it is an army that costs less (no meds, if I am correct)
if tednlou2 were to start meds (at a cost,...) he would end up with a most likely identical number of troops (CD4 count would raise, but not hundred folds) but more robust (a higher %). It's a bet.
See Fidel Castro' army or north Korean army. None of these dictators will be defeated on that front, they will simply be gone for other reasons (age...)

Hope this clarify things. Eric

[wtfimpoz]

Above CD4 500, cd4% is a better indicator of decease progression.

Your defense army is stuck at WWI front. there are enough soldiers (>500) but if % lowers it means that level of rotation is high ... The problem is that on that front, there is a rebellion, CD8s are killing CD4s, which are soon replaced, but... A low percentage means that there are less CD4 (loyalists) than CD8 (killers)

As a result...

Soldiers are younger, less experienced, the number of officers has decreased. More and more inexperienced recruits are coming to the front, so , yes, on a snapshoot image, there seem to be enough soldiers to protect against enemies (infections)... they may be able to reply to one or 2 attacks, but, no more... hence, disease progression.

%38 is NOT low. 30 is the minimum for a reference range

% 20 is not normal and not life threatening. In terms of disease progression there is a plateau from 15 to 25 where differences in % are not statistically nor clinically very relevant , BUT, in untreated patients, once the % goes lower than 15% , then disease progression goes much faster (accelerates) which is why %14 is (or was) considered as a criteria for AIDS.

wtfimpoz's army is not numerous but robust and well trained (like the Swiss army, a country that has never been invaded). It is also a costly army (meds...)
tednlou2 's army is numerous but less robust (like Saddam's former army): good enough against a minor enemy (Kuwait) but no match against a major intruder (US) , on the other hand, it is an army that costs less (no meds, if I am correct)
if tednlou2 were to start meds (at a cost,...) he would end up with a most likely identical number of troops (CD4 count would raise, but not hundred folds) but more robust (a higher %). It's a bet.
See Fidel Castro' army or north Korean army. None of these dictators will be defeated on that front, they will simply be gone for other reasons (age...)

Hope this clarify things. Eric

urm, are you saying that I'm like Kim Jong Ill? 

[littleprince]

wtfimpoz's army is not numerous but robust and well trained (like the Swiss army, a country that has never been invaded). It is also a costly army (meds...)
tednlou2 's army is numerous but less robust (like Saddam's former army): good enough against a minor enemy (Kuwait) but no match against a major intruder (US) , on the other hand, it is an army that costs less (no meds, if I am correct)
if tednlou2 were to start meds (at a cost,...) he would end up with a most likely identical number of troops (CD4 count would raise, but not hundred folds) but more robust (a higher %). It's a bet.
See Fidel Castro' army or north Korean army. None of these dictators will be defeated on that front, they will simply be gone for other reasons (age...)

Great so at VL 90 and 14% my army is kinda like Dads Army after a heavy night on the booze. It sits around and just says what ever... you deal with it.

[eric48]

are you saying that I'm like Kim Jong Ill?

Nope : wtfimpoz's army is like  a Swiss army small in number , great in strength/experience; in other words you can count on it (it has never been defeated...)

My point about some armies is that they have been able to maintain status quo (truce) despite being under equipped, less experienced and numerous, simply because time plays in their favor.

As for wtfimpoz being like Kim Jong Ill... no, no, no ... I like the looks of Kim Jong Ill so much better ; - )

"... VL 90 and 14%... " ?? this discussion is about CD4 and CD4%. Do you mean CD4 90 and CD4% 14 ?
Meds or no meds? (in other words do you have the nuclear arsenal or not)
if CD4 90 and CD4% 14  and no meds: you will not last long... rush for meds
if CD4 90 and CD4% 14  and meds (or even VL 90 and CD4% 14  and  meds) situation will improve but you have to remain on higher alert until it does.

I kind of like the army analogy it make things easier to apprehend and anticipate. And also as one US strategists once said: you have to do with the army you have not the one you 'd wished you have ...


 Good luck guys!

[wtfimpoz]

are you saying that I'm like Kim Jong Ill?

Nope : wtfimpoz's army is like  a Swiss army small in number , great in strength/experience; in other words you can count on it (it has never been defeated...)

My point about some armies is that they have been able to maintain status quo (truce) despite being under equipped, less experienced and numerous, simply because time plays in their favor.

As for wtfimpoz being like Kim Jong Ill... no, no, no ... I like the looks of Kim Jong Ill so much better ; - )

"... VL 90 and 14%... " ?? this discussion is about CD4 and CD4%. Do you mean CD4 90 and CD4% 14 ?
Meds or no meds? (in other words do you have the nuclear arsenal or not)
if CD4 90 and CD4% 14  and no meds: you will not last long... rush for meds
if CD4 90 and CD4% 14  and meds (or even VL 90 and CD4% 14  and  meds) situation will improve but you have to remain on higher alert until it does.

I kind of like the army analogy it make things easier to apprehend and anticipate. And also as one US strategists once said: you have to do with the army you have not the one you 'd wished you have ...


 Good luck guys!

The weird thing is, I think my infection was fairly recent.  I had a neg result in 01/01/09.  Wouldn't my numbers be more common in somoene whose system had been under slow pressure from HIV?

(shrugs)

Thanks a lot for your input BTW. 

[tednlou2]

tednlou2 's army is numerous but less robust (like Saddam's former army): good enough against a minor enemy (Kuwait) but no match against a major intruder (US) , on the other hand, it is an army that costs less (no meds, if I am correct)
if tednlou2 were to start meds (at a cost,...) he would end up with a most likely identical number of troops (CD4 count would raise, but not hundred folds) but more robust (a higher %). It's a bet.
See Fidel Castro' army or north Korean army. None of these dictators will be defeated on that front, they will simply be gone for other reasons (age...)

Hope this clarify things. Eric

Very interesting way of looking at things.  This is what I'm taking into account about when to start meds.  My doc, who I'm still trying to decide whether I have confidence, says I'm fine for a long time.  He told me when I got to CD4 350 we would start meds.  I told him I doubt I would want to wait much past 500.  And, then there's the %.  He didn't seem concerned with the percentage.  As I said, when you read treatment guidelines and studies, they rarely mention the %.  It leaves a person wondering what to give more weight to when experts don't talk much about the percentage.

When you say my numbers wouldn't be any match for a major invader, what are you talking about?  From what I've read, colds and flu use a different part of the immune system.  However, when I got bacterial pneumonia, my % was 19.  So, that obviously makes me wonder whether I'm more likely to get sick with things like pneumonia once the percentage gets below 21% even if I had a CD4 of 1000.