GAY PEOPLE'S CHRONICLE OCTOBER 15, 1993

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HEALTH WATCH

CD4+ counts: what

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by Dr. Elliot Neufeld

and Gary Avis

CD4+, T4 Helper, and T4 Lymphocyte cell counts: What are they? They all refer to the same thing! These three terms are all used to refer to counts of an important infection-fighting blood cell. More specifically, the CD4+ is a lymphocyte. A lymphocyte is a type of white blood cell that is an important part of the body's immune system. Having a count of the CD4+ lymphocyte is important because it can be helpful in determining both the relative progression of the disease (even though other cells may be attacked by the virus) and the effectiveness of any treatments for HIV.

One peculiar fact about HIV is that it only attacks one part of the immune system. The rest of the body's immune system is usually relatively unaffected. This is the reason why HIV-infected people often only get opportunistic infections (which an uninfected person with a healthy immune system can usually fight off easily) and not a steady progression of common infections like the common cold and the flu.

In a healthy adult, a CD4+ count of 1,000 per cubic millimeter (or higher) is considered normal. For children, the normal count

is usually somewhat higher. If you are HIVinfected, having a count done is important, but there are some important facts to consider:

1. The count is not the definitive indicator of your health. Some people have had serious opportunistic infections with CD4+ counts below 200 per cubic millimeter, while others have remained relatively unaffected despite having low counts.

2. It is possible for your counts to increase. Reduction of stress, healthier lifestyle habits, and effective treatment of HIV infection can result in increased CD4+ counts.

3. The CD4+ counts can show fluctuation for other reasons including: The time of day the sample is drawn (CD4+ counts rise and fall from hour to hour and also show a variation based on the time of day); and different labs performing blood sample analysis. There may be variations in the handling of the blood sample that can result in differing results.

HIV-positive individuals should have their CD4+ counts measured at least every six months and more frequently if the count is below 500 per cubic millimeter. For further questions, please consult your doc-

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