It’s difficult to say what’s normal with HIV/AIDS because the clinical picture can be quite variable. As I mentioned before, there are no absolutes on the CBC. In an HIV+ individual with normal immune function who receives no treatment, the average length until the onset of AIDS in about 8 years. Older patients tend to progress more rapidly and younger patients will usually have a later onset. When AIDS is diagnosed the patient will generally present with an array of opportunistic infections that will reflect on the CBC.
The CBC values you’ve given are “relatively” within the normal range. The neutrophils are a little high (percentage-wise), which could suggest a bacterial infection or inflammation. It could also reflect a relative increase if your lymphocytes are little low but your leukocytes are normal (and your leukocyte values are within a normal range). There are two basic stages of development for neutrophils: 1) band neutrophils (bands) and 2) segmented neutrophils (segs). Bands are immature forms and segs are mature neutrophils. The percentage you gave is for the segs. The percentage of bands would give the clinician more diagnostic information. Normally there should be 0% of bands detectable on the CBC. If there is an increase in the bands, we call that a “left shift” and that almost always indicates an acute infection.
The lymphocytes percentage is a little on the low side (slightly), which could be accounted for by the virus. However, lymphocyte counts can be low if you are taking corticosteroids or are in a high stress state. Lymphocytes can be divided into two categories: 1) T-cells and 2) B-cells. HIV attacks and destroys T-cells that have a special maker called CD4+. This is why your healthcare provider is constantly concerned with the “CD4+ count.”
If a person has been HIV positive for 12 years or more without treatment with that CBC, I would consider that pretty exceptional. Based on the “average,” I would expect more overt signs of AIDS with alterations on the CBC. But, those values are quite possible and would indicate a relatively healthy person given that there are no other issues involved. However, your physician should have the final say on that.
Remember as cflas mentioned above, the CBC cannot be used in and of itself to diagnose HIV/AIDS, and must be taken into account with the total clinical picture of the patient. Also keep in mind that many labs have their own parameters of normal ranges, which can vary slightly.
Hope that helps some.
Originally Posted by tracygirl
After 12+ years after infection with no treatment would it be normal/commen to have a total WBC of 8700 - lymphocytes being 2800(32%) and neutrophils being 5130(59%) and monocytes, eosinophils and basophils all with normal numbers/percentages as well. RBC, hemoglobin, etc all well within normal limits as well?