From: byrne@soma.UMDNJ.EDU (Bruce Byrne)
Newsgroups: sci.med
Subject: Re: T4 and T8 counts
Date: 11 Nov 92 17:33:37 GMT

king@reasoning.com (Dick King) writes:


>The blood bank at which i donate regularly called a couple of weeks ago.

>They said:

>  * we tested donors for T4 counts in 1984.  Yours [mine] was in the 290's,
>    which is about half the bottom of the normal range.  Your T4/T8 ratio was a
>    very low 0.45 [minimum normal is 0.85].

[stuff deleted]

>  * You continue to donate, and your blood continues to come up clean and even
>    CMV negative [premature infant-worthy]

>  * could you give us another small sample?

[more stuff deleted]

>Apparently the NIH has asked them to retest all people who tested with low T4
>counts in 1983 or 1984, but still donate regularly [3-4/yr in my case].  This
>blood bank had a couple of hundred low T4 counts, 2% of which turned out to be
>HIV+ and all but six of which have stopped donating at THIS PARTICULAR blood
>bank since 1984.  

[more stuff deleted]

>They say that there's nothing to worry about, and that there's no reason to
>skip my next scheduled donation in a couple of weeks.  I therefore am not
>consulting with any doctor, but could any net.hematologists comment on all of
>this? 

Would a net.molecular.biologist do?

The story all adds up; I agree, there's nothing to worry about.  You will 
recall the flurry of stories last summer about "AIDS" without "HIV."  These
were often (1) very sick folks who (2) had low CD4's and (3) had no 
immunologic or molecular markers of having been infected with HIV.  Since
both the molecular and immunologic tests for HIV require that the blood
banks know what they're looking for, the (remote) possibility that there
was a new infectious agent causing an AIDS-like syndrome needed to be
investigated.  The important finding (absolutely distinctive from the
early days of AIDS before HIV was implicated) was that these sick 
folks fit into 
no consistent epidemilogic class.

On the way in, this morning, I heard on the news that NIH (I believe) was
undertaking a study to see if the "low CD4" condition could be transmitted
by transfusion.  Here's where you come in.

Curiously, your blood bank was doing some expensive testing back in 1984,
probably related to the AIDS epidemic.  They kept records of exceptional
results, and then pulled you out again.  My guess is that they will trace
your donations to those recipients who recieved the (usually fractionated) 
components of your blood and then examin their health
status and, perhaps, do a CD4 analysis on them.

My problem, in trying to understand the issue, is that there is not 
nearly enough information on CD4 results on asymptomatic individuals
to know what a low CD4 count means.  It could be trivial.  I recall a
report some time ago that described a population having a slightly 
diverse CD4 epitope that did not bind to commercial antibody and 
therefore these folks tested as low CD4.  Other folks may just usually
be low.  But since the test is relatively expensive, it hasn't often
been applied to healthy populations so that the medical consequence of
low CD4 (if any) could be followed.

The stress on the blood banking system to produce an unusually safe
product (unreasonable, to my mind, but then that is my mind) has led to
the study that apparently involves you.  I'd hope that somebody might 
also look at the outcome for folks like you and give us some information
about low CD4's in healthy individuals.

>Perhaps it's an experiment to turn healthy folks into hypocondriacs ;-) ?

You don't need an experiment to do this; just call a press conference.

bcb

>-d