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Author Topic: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)  (Read 1395 times)

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Offline windupwindbird

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Hi, before starting treatment around late-January I got a cd4 count of 420 and a cd4% of 22 in my initial lab results. Itís been around 4 and a half months of treatment and I had my second lab tests 6 days ago. They  showed that my cd4 count dropped to 330 but my cd4% rose to 27. Is this a normal discrepancy? Why did my cd4 drop but my cd4% increase? Should I be worried? Iím still waiting for my VL load results to be ready so I donít know the number. Thank you!

Offline Jim Allen

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #1 on: May 27, 2019, 03:26:47 am »
Hiya,

Welcome to the forum, sorry to hear about the diagnosis but glad you are on treatment.

The CD4 can go up or down by 100 points on the same day, the CD4% is a more stable marker than the absolute CD4 count, that said neither are a measurement of overall health or that treatment is working, the main goal of treatment is simply to suppress HIV. Looking at CD4 counts becomes rather irrelevant once you have reached that goal

Quote
Iím still waiting for my VL load results to be ready so I donít know the number. Thank you!

That's the one you need, i'm presuming you have an initial VL count though?

Best, Jim
« Last Edit: May 27, 2019, 03:28:51 am by Jim Allen »
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Offline windupwindbird

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #2 on: May 27, 2019, 05:10:47 am »
Hi Jim,

Thank you for the response. No initial VL count. I wasnít asked to have it taken.

Offline Jim Allen

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #3 on: May 27, 2019, 05:33:33 am »
Okay.

Well keep us posted once you have a VL, I'm sure things will be fine.

How are getting on with ART and, you feeling for the rest?

Best, Jim
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Offline leatherman

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #4 on: May 27, 2019, 06:35:07 am »
No initial VL count. I wasnít asked to have it taken.
started meds in Jan with no viral load? Yes you need to check with your doctor about this. As Jim pointed out the cd4 count really only matters in showing whether you are under 200 and vulnerable to opportunistic infections. That count has no bearing on whether your treatment is working nor does it show how healthy you are.

The viral load number though is the most important number! If the HIV meds are working, the viral load goes to "undetectable". and that's the real goal you're trying to reach. There is nothing you can do to help your cd4 count (because it's based on your genetics) but becoming "undetectable" (which means knocking HIV down to the lowest level possible) is the gold standard because HIV isn't adversely affecting you at that point. Also if you're undetectable for at least 6 months, it's been proven that you can't transmit HIV (U=U which is Undetectable = Untransmittable. also known as TasP which is Treat as Prevention)

So the viral load count is what really matters while living with HIV. Definitely talk to your doctor and get a viral load count ASAP (it's hard to imagine you've been on treatment for half a year without any viral load test having been done). Without that count, you can't know whether your HIV treatment is working.
leatherman (aka mIkIE)


chart from 1992-2017
Tivicay/Prezcobix

Offline windupwindbird

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #5 on: June 01, 2019, 12:17:51 am »
Hi guys, thank you all for replying. My viral load is <40. I can finally stop worrying. :)

Offline windupwindbird

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #6 on: June 01, 2019, 03:14:54 am »
Hi just a follow-up question, why does my test still say HIV-1 detected but my viral load indicates <40 copies/mL?

Offline windupwindbird

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #7 on: June 01, 2019, 04:29:55 am »
Hi, I just got my viral load result today and it indicates ďHIV-1 DETECTED <40 copies/mLĒ. Should I be undetectable already since the machineís detection limit is below 40. Is there a discrepancy in the results? Thank you.

Offline Jim Allen

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #8 on: June 01, 2019, 05:18:18 am »
Because it's detected but below the threshold to quantify.
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HIV Transmission and Risks
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HIV Testing
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HIV TasP
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HIV prevention
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PEP and PrEP

Offline windupwindbird

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #9 on: June 01, 2019, 05:39:00 am »
Thank you for the reply. Is this usual? Shouldnít my result say Iím undetectable or ďtarget not detectedĒ since my viral load is below detection limits? Sorry if this post seems alarmist. Iím trying to understand the result. :)

Offline Jim Allen

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #10 on: June 01, 2019, 05:55:35 am »
Hiya,

It's perfectly fine, it's just how the lab chooses to report it. The result simply means there is a VL between 0-39 copies/ml but its too small for it to correctly quantify. I.e its below the threshold they can accurately messure.

Undetectable (UD) is a lab term, now from a treatment perspective, anything below <50/ml is accepted as virally suppressed (UD) and, for no risk of sexual transmission UD is classed as <200/ml (for 6+ months) 

Ultimately you could ask a research facility to measure the VL down to 1 copy/ml, if you really wanted to know the number of copies however there would be no clinical, treatment difference between 0 - 50 copies. 

Relax  ;) You are UD, keep taking your meds as they are working.
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

Offline daveR

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #11 on: June 01, 2019, 06:00:23 am »
Less than 40 is the same as being undetectable. The machine at your hospital can accurately count 40 and above copies of the virus. However that does not mean that it cannot see if you have some but less than 40, this is why they say detected.It is nothing to worry about. Many hospitals have a lower measurable limit of 20, there will be laboratories that can accurately count less than that. All irrelevant to us. You are doing fine.

Dave

Offline leatherman

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #12 on: June 01, 2019, 08:05:41 am »
there would be no clinical, treatment difference between 0 - 50 copies. 
0-200 copies ;)
leatherman (aka mIkIE)


chart from 1992-2017
Tivicay/Prezcobix

Offline Jim Allen

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Re: 2nd Lab Test (cd4 count dropped but cd4 percentage increased)
« Reply #13 on: June 01, 2019, 11:17:24 am »
200 for transmission
HIV 101 - Everything you need to know
HIV 101
Transmission and Risks:
HIV Transmission and Risks
Read more about Testing here:
HIV Testing
Read about Treatment-as-Prevention (TasP) here:
HIV TasP
You can read about HIV prevention here:
HIV prevention
Read about PEP and PrEP here
PEP and PrEP

 


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