Low CD4 Count and seroconversion

[Pumpkinseed77]

Please read the following abstract:

To evaluate the normalization of lymphocyte subsets several years after autologous peripheral blood stem cell transplantation (aPBSCT) and to detect any differences based on the underlying lymphoproliferative diseases, we analyzed the immunological recovery of 149 patients with Non Hodgkin's Lymphoma (NHL), Hodgkin's Disease (HD), Multiple Myeloma (MM). Lymphocyte recovery was assessed before the transplant, on days 15, 30, 60, 90, 120 and on years 1, 2, 4, 6. Analysis of a total of 709 lymphocytes, including total lymphocyte count, CD3 + , CD4 + , CD8 + , CD4 + /CD8 + ratio, CD19 + , CD3 + HLA-DR + , CD16 + 56 + , was performed. The normalization of total lymphocyte counts was achieved between days 14 to 22 following PBSCT. CD3 + cells count showed a normalization after 2 years in the HD and NHL groups and after 4 years in MM group. CD4 + subset achieved normalization during the sixth year in the 3 groups. The CD8 + and CD19 + lymphocytes subsets achieved normal values in the 3 groups at day 60 and at day 120 respectively. CD16 + 56 + and CD3 + /HLA-DR + lymphocytes showed median values above the normal range starting from day 30. Immunological recovery was similar in all 3 groups. Moreover, the recovery of all subsets evaluated was similarly demonstrated within 6 years after aPBSCT."

Source: http://www.informaworld.com/smpp/content~content=a713680528&db=all

QUESTION:
I had a stem-cell transplant October 2001 due to non-hodgkins lymphoma.  From what I can tell, by my last HIV test, (April 2007), all lymphocyte levels, MINUS the cd4 count, would be expected at a very normal level.  The cd4 count would not recover until year 6(ish).

Okay, I know that none of you are oncologists, but my question is about cd4 counts.  

Last known and CONFIRMED exposure for me and it was high risk, btw, was November 2003.  Negative HIV= October 2005 and April 2007.  Assuming that my cd4 count was still off, but not by a huge amount, could seroconversion be delayed for 3.5 years?

I had another sample taken last week for ELSA testing, but I did not take into consideration the effects of chemo, stem-cell and radiation on an antigen test when the test was performed years later.  I am now just thinking this all through (and shaking from nerves the entire time).  

I just read that lower cd4 counts do not necessarily delay the progression of the virus.  See the link below.

http://journal.shouxi.net/qikan/article.php?id=202016

I would assume (you know what they say about assuming) that this would apply to seroconversion as well.  BUt I don't know.  To top it all off, I have none of my oncology records with me (we move all the time due to husband's job and I gave all my copies to my last primary care clinic for records... and we moved again, me leaving the records behind in the rush.)  Therefor, I have NO idea what my counts were.

God, I hate this.

BTW, why am I just now concerned about HIV?  Just found out that I was exposed to a confirmed case back in 2003 just months before he was diagnosed with AIDS.  Dummy here had no idea, therefor I never really thought anything about my routine HIV screenings.  

This is not a regular delayed seroconversion thread, so please refrain from jumping on me with policy.  I was one sick puppy for an entire year do to treatment for non-hodgkins lymphoma and my immune system was in the garbage.  I hope to heck that it was recovered enough for my last test to pick up antibodies.  If I had only known about his diagnosis, I would have had the RNA test run.  Now I have two babies who *maybe* have been exposed, I breastfed both of them and I am freaking out.

I will keep everyone posted.  I am also getting my records transfered up here and into an oncologist for a followup PRONTO.  

ANY input is welcome, as well as prayers.  I cannot seem to pray at the moment.  HIV is so unpredicatable and I see little divine providence in regards to who gets it and who does not.  Cause and effect, with lots of luck involved.

I am just so scared... if I had only known I would have taken this all into consideration YEARS ago and been done with the whole thing.

Peace.

[terrywane80]

U have been exposed for too long to produce enough antibodies 3.5 yrs. the tests would have detected. relax

[Pumpkinseed77]

Also, could someone who is smarter than me (and not as shaken) read this over and tell me if it indicates that low cd4 counts would not factor into a LONG delay in seroconversion?

The study actually makes me think that a person with initially low cd4 counts would progress the same as those indivduals with normal cd4 counts... perhaps even progress more quickly.

Thanks again.

http://aje.oxfordjournals.org/cgi/reprint/145/7/629.pdf