[Question #3162] HIV delayed seroconversion, low cd4/8 ratio with exposure and ars symptoms

39 months ago
Hi Dr.

I have posted my notes about 17 months ago (which you can see it in my history as well). I understand that repeated anxiety driven questions are not answered and i understand logic behind those as well.

As I described, i didn't had any additional exposures in between 20 months ago and now. However, my condition is still te same and possibly going in wrong direction.

I'm on 50mg medication of depression from last 3 months and its not helping me much. Atleast i get 8 hrs. Unrefreshing sleep with medication.

The reason for my concerns are exposures, ars symptims and cd4/8 history.

I have worked with pcp,infectious diseases, gastro, psychiatric drs in this time frame...i had cbc, std panel, thyroid, stool test, colonoscopy, cd4/8, ebv, cmv..all sort of test done...things are different but normal from any drs. Prospective....

My biggeste concern is, my body reaction on daily basis and cd4 history, even though my hiv test is NEGATIVE 86 weeks

Cd4 1622 , 1.53 ratio @ 8 weeks
Cd4 851 , 1.36 ratio @ 18 weeks
Cd4 1056 , 1.45 ratio @ 24 weeks
Cd4 1446 , 1.4 ratio @ 42 weeks
Cd4 1398 , 1.5 ratio @ 63 weeks
Cd4 1241 , 1.05 ratio @ 88 weeks

As you can see drop of 50% at 18 weeks and cd4/8 ratio of 1.05 now, still hiv negative.

PLEASE HELP.

1) Is this close to hiv? I'm not going to talk about symptoms since i know those are nin specific.
2) whats the cause of 50% drop in cd4 at 18 weeks and elevated cd8 (reducing cd4/8 ratio) at 88 weeks.
3) who else i need to consult?
4) can i still plan a baby with hiv negative person without fear of infecting others?
5) could this be different strain of hiv which is not getting detected by cirrent pcr tests (outside usa test)?
6) does hiv antobody creation process requires atleast minimal amonut of virus? Possible that its not getting created as i may have less in numbers?
7) does long term nonprogresser are antibody positive and have cd4/cd8 ratio below 1.0?

I'll appreciate your help on this.



Edward W. Hook M.D.
Edward W. Hook M.D.
39 months ago
It saddens me that you have not been able to move forward despite the advice that both Dr. Handsfield and I have provided to you.  Nothing we said before has changed.  I am pleased to hear that you have sought help from other doctors and am sorry that you have not found a doctor who can help you.  It is not clear from your posts whether you have heard similar responses from them as you have heard from us or something different.  My sense is that either you have not found the right doctor or that you are not able to hear what they may be telling you.

As we have told you in the past, the CD4 count is changed by a lot of other illnesses and has not been a part of the possible diagnosis of HIV for over 30 years, its role having been replaced by modern HV antibody and antigen tests such as you have had.  Your repeated negative HIV test results prove, without question that your abnormal CD4 count are NOT due to HIV.  What might be affecting them I cannot say and if you have not spoken with one yet, I would suggest you seek the input of a clinical immunologist who might help put things in perspective.  THIS IS NOT HIV.  As for your specific questions:

1) Is this close to hiv? I'm not going to talk about symptoms since i know those are nin specific.
See above.  I do not deny that you may be having symptoms but I can assure you they are not due to HIV.  You should seek the advice of other doctors as to what might be causing your persisting symptoms. 

2) whats the cause of 50% drop in cd4 at 18 weeks and elevated cd8 (reducing cd4/8 ratio) at 88 weeks.
See above and earlier replies.  The CD4 count fluctuates considerably from day to day and hour to hour and is affected by many other illnesses.  It should not be used in the way that you are trying to use it.

3) who else i need to consult?
See above.  Perhaps a clinical immunologist.  In addition, you would be well served by a regular doctor who can help you look for other illnesses, as well as perhaps a mental health professional who might help you to work through your erroneous fixation on HIV.

4) can i still plan a baby with hiv negative person without fear of infecting others?
yes

5) could this be different strain of hiv which is not getting detected by cirrent pcr tests (outside usa test)?
No.

6) does hiv antobody creation process requires atleast minimal amonut of virus? Possible that its not getting created as i may have less in numbers?
This is not a realistic concern.

7) does long term nonprogresser are antibody positive and have cd4/cd8 ratio below 1.0?
Most long term non-progressors have relatively normal CD4 counts although there is much variation.  There is no credible reason to think that you might be a long term non-progressor.  EWH
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