My first blood work

[UALaw77]

CD4= 743

VL= 319,000

My first reactive blood sample was drawn on November 13th.  This CD4 and VL count was from blood drawn on December 20th.

The doctor said that this indicated that I had a healthy immune system which had taken a little hit from the initial HIV infection.  The doctor also said that I could expect my CD4 to rise again and for my VL to start coming down.  They took additional blood today.

Any other interpretation of this data?

Many thanks for your wisdom,

Danny

[indyguy]

Thats good news it sounds like. I am waiting to get a doctor for my first round of tests

[rick21007]

Danny--good for you!  Means you are off to a running start to stay on top of things.  Long may it wave!!

Rick

[Boo Radley]

Danny,

The CD4 count is great by any standards and the vl is rather high though nowhere near as bad as it could be.  Are you on meds?   If you are on meds you can count on your doctor's opinion to prove correct.  If you're not on meds I'm not sure what the doc is basing his/her opinion on.   With a vl of 319,000 I'd guess you are on meds.

Best of luck with the next lab work.

Boo

[Andy Velez]

UA, good to hear from you again.

Keep us posted on how the numbers go and on anything else you want to talk about.

Cheers,

[koi1]

Good numbers. You will probably not need meds for a very long time, especially if you take care of yourself. I hope you are feeling better. Don't be a stranger.

rob

[Central79]

Hey Danny

Congrats - these are really good numbers. Early in HIV infection, there is a viral spike (high VL) and CD4 drops, as the  spike comes down, CD4 typically rises and then declines slowly over a number of years until the point where you have to start medication (200-350, depending on where you live)! The average decline is 45-50 cells/year.

The way I was taught to think about it is that HIV is like being on board a train heading for a cliff (not the best metaphor!). Your CD4 is the distance to the cliff, and your VL is the speed the train is going. I've read more recent research that shows that VL alone may not account for all of the CD4 change, and that host factors (ie your body and it's response to having HIV, no matter where your VL is) play a part.

In the UK we don't tend to start meds based on viral load, although I know you guys do in the US. This has paid off for me as my initial bloodwork (Jan 06) had my VL > 500,000. It's come down now and continues to fall. There's also a trend in the US to start therapy earlier than in the UK, although I think we're heading your way on that. With new and better drugs I'm certainly going to start by the time my CD4 hits 350. They're starting a trial in the US to see if it might be worthwhile starting at even higher CD4 counts.

I guess the other thing to tell you about it that CD4 varies naturally. I got a bit of a shock last time I went as my CD4 had dropped from 840 to 680 in 3 months. This is where CD4% comes in, and you should pay attention to this as well. Basically it shows the % of all of your lymphocytes that are CD4. If your CD4 count drops, and your % stays the same then you know it's due to a mass effect - ie ALL of the white blood cells moving in and out of the blood en masse. Over time the %, as well as absolute number of CD4, drops as you progress. So my % stayed the same = mass effect! CD4 can vary as much as 40% depending on the time of day, whether you're a smoker, periods in girl... yada yada. I got my head too much into the numbers for a while - spare yourself!

Peace,

Matt.