December #119 : Weighing CD4 Counts - by Bob Lederer

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Table of Contents
 

On the Cover-Juliano Innocenti

Melting the Winter Blues

Higher Ground




Sex in the Age of Meds

WHY...December 2005

Steps to the Future

The Fright Before Xmas

Striking Oil

A Gift to Yourself

A New Year Bathed in Promise

Weighing CD4 Counts

Trainer's Bench - December 2005

The Legal Eye - December 2005

Sexy Holiday Toys




Footloose

LeRoy Whitfield 1969-2005

Earthwatch - December 2005

Tripped Up

Buzz - December 2005

Out of the Blues

A Lifeline for All

Yesterday's News

As the Virus Turns

Mentors - December 2005




Mailbox - December 2005

Editor's Letter - December 2005



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV



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December 2005


Weighing CD4 Counts

by Bob Lederer

There’s more than one way to rate the strength of your immune system

You’re always hearing that your CD4 count measures how well your immune system is doing with HIV. But there’s another measurement to consider: the CD4 “percentage.” This number tells you what percentage of your lymphocytes (infection- and cancer-fighting white blood cells) is made up of CD4s. The percentage tends to be more stable than the CD4 count—which can drop during short-term events like a yeast infection, a vaccine or serious stress. As long as the percentage is safe, temporary dips in count shouldn’t cause alarm. Here’s how four HIV docs surveyed by POZ use CD4 percentages in decision-making:

STARTING MEDS: All say CD4 percentage, CD4 count and viral load should be considered. Many docs suggest starting meds—if a patient is ready to handle them—after repeated CD4 counts below 300 to 350. As for percentage, a recent study suggests that people with HIV are at risk for illness if it dips below 17%. “If this appears on two or three reports, I strongly recommend starting meds” regardless of CD4 count, says New York City’s Lloyd Bailey, MD. Antonio Urbina, MD, also a New Yorker, and Chicago’s Beverly Sha, MD, start at 14%. Lisa Sterman, MD, of San Francisco, doesn’t look for a set CD4 count or percentage, because she finds that each patient has a variety of numbers and health characteristics to consider. “And for women, who tend to have lower CD4 counts,” Sterman says, “percentages are more important.”

SWITCHING COMBOS: For Sha and Sterman, changes in viral load, not CD4s, suggest regimen changes. Urbina adds, “If CD4 count and percentage drop, I look for a hidden infection like TB or syphilis [to explain the drop], rather than switching.”  

STARTING PREVENTIVE MEDS: As the immune system deteriorates, people with HIV become vulnerable to opportunistic infections like pneumocystis carinii pneumonia (PCP). Prophylactic (preventive) treatments are available. Federal guidelines (and most AIDS docs) call for starting PCP prophylaxis at CD4 counts below 200 or CD4 percentages below 14. Preventive treatments for other infections are recommended only at lower CD4 counts. 


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