Being Alive Newsletter, Being Alive/Los Angeles - June 1992
Mark Katz MD and reported by Jim Stoecker

The 1988 International AIDS Conference in Stockholm included a study of twenty men in various stages of HIV infection. For five consecutive days, T-cell counts were done for each participant. One count was done in the morning and the second in the late afternoon. Researchers found that 60% of the participants doubled or halved their own T-cell count within the five day period. (Note that most study participants were probably at a low range level. We know it is more likely that one fluctuates from 100 to 200, than it would be to bounce from 400 to 800.)

A recent study in the Journal of Infectious Diseases confirms this daily rhythm in CD4 level. Researchers looked at the counts of three HIV+ groups at varying levels of symptoms. One count was taken at 8 am and a second at 10 pm. For the asymptomatic group, the mean count was 426 at the 8 am test and 495 at the 10 pm test. Similar fluctuations were noted for those at a lower T-cell level, as well as for an HIV- control group.

We can say that T-cell counts run 10-20% higher if done late in the day, rather than early in the day. It makes no sense, however, to conclude that T-cell counts should be done late in the day in order to get a higher count. What these studies tell us is that we cannot take any one T-cell value and make decisions based on that one value. We need to look at the trend over a period of time in order to make intelligent decisions about a treatment course.
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