CD4-CD8 Test Interpretation

[sorin]

@sorin
I had this infection way before I developed CFS and I was very healthy at that time.

Sorry, to what infection do you refer?

 

[Mij]

@sorin

HSV that caused the mouth ulcers etc.

 

[sorin]

it means that elevated an inverted CD4/CD8 Ration caused by elevated CD8 is a normal finding in a portion of the population. This alone is not enough to assume someone has an issue with their health. Just as a % of healthy people have a positive ANA, positive ANA alone does not indicate illness.

I am not sure about this, even I admit that I would like that what you said to be true. But if it would be true, and if it would be normal a low ratio, then why on the blood test report is given the "normal range" [1 - 3.7]? Consequently my result of 0.69 is not normal according to the report ?!?

On the other hand, I was thinking, could the CD8 increase mean some form of cancer?

 

[TrixieStix]

I am not sure about this, even I admit that I would like that what you said to be true. But if it would be true, and if it would be normal a low ratio, then why on the blood test report is given the "normal range" [1 - 3.7]? Consequently my result of 0.69 is not normal according to the report ?!?

On the other hand, I was thinking, could the CD8 increase mean some form of cancer?

Factors that can influence how high or low your CD4 count is....

• CD4 counts tend to be lower in the morning and higher in the evening.
• Acute illnesses such as pneumonia, influenza or herpes simplex virus infection can cause CD4 counts to go down for a while.
• If you have a vaccination or when your body starts to fight an infection, your CD4 counts can go up.
• Chemotherapy can cause CD4 counts to go dramatically down.
• Fatigue and stress can also affect test results.

"Low CD4+ T lymphocyte counts (CD4 counts) are associated with a variety of conditions, including many viral infections, bacterial infections, parasitic infections, sepsis, tuberculosis, coccidioidomycosis, burns, trauma, intravenous injections of foreign proteins, malnutrition, over-exercising, pregnancy, corticosteroid use, normal daily variation, psychological stress, and social isolation."

"Finally, there are a number of people who are completely healthy and who have low CD4 counts for no apparent reason."

"Reports concerning lowered CD4 counts in people who are HIV-negative have been widely ignored. These reports show that CD4 counts commonly fall extremely low, especially if a person suffers from certain conditions. These conditions include a variety of viral illnesses, bacterial infections, parasitic infections, sepsis, septic shock, multiple organ system failure, tuberculosis, coccidioidomycosis, burns, trauma, transfusions, malnutrition, over-exercising, pregnancy, normal daily variation, psychological stress, and social isolation. In addition to lowered CD4 counts, other immune system changes occur that are also identical to those seen in people diagnosed HIV-positive, including reduced CD4/CD8 ratios, increased CD8 cells, reduced lymphocyte function, anergy, increased antibody levels, atrophy of lymphoid organs, and general suppression of cell-mediated immunity. These effects can take weeks or months to return to normal, and, if there are recurrent infections or if multiple factors are present, the low CD4 count could take much longer than this to correct, or may even stay low indefinitely."

"Little is known regarding factors associated with CD4 and CD8 cell numbers in HIV-negative individuals."

"Multivariate analyses of CD8 cells revealed that lower age, higher BMI, Hispanic race/ethnicity; current smoking, injection drug use, and Hepatitis C infection were independent predictors of higher CD8 cell counts. Multiple demographic and behavioral factors may influence CD4 and CD8 counts in HIV-negative women."

 

[sorin]

@TrixieStix
My problem is not necessarily with the CD4 count which is (866, 30%) but with the high CD8 which seems abnormal (1259, 44%). That makes the ratio to decrease to 0.69

 

[TrixieStix]

@TrixieStix
My problem is not necessarily with the CD4 count which is (866, 30%) but with the high CD8 which seems abnormal (1259, 44%). That makes the ratio to decrease to 0.69

I wanted to post some information about low CD4 just for reference, but the last 3 sections refer to CD8.

My takeaway from the research I've done is that CD8 count is almost exclusively used to monitor people who are HIV-positive and that outside of that it's not really been established what other things have the potential to cause elevations (pretty sure it's established that CD8 is higher when your fighting an infection). Perhaps an elevated CD8 count hasn't proved to be of much importance outside of HIV treatment/diagnosis?

 

[sorin]

My takeaway from the research I've done is that CD8 count is almost exclusively used to monitor people who are HIV-positive

I thought that only CD4 is important for HIV positive people. They would want to know when CD4 goes below that threshold of 350. But why would be they preoccupied about CD8?

 

[TrixieStix]

I thought that only CD4 is important for HIV positive people. They would want to know when CD4 goes below that threshold of 350. But why would be they preoccupied about CD8?

"CD4 "helper" T-cells are the primary target of HIV and CD4 cell count is a key measure of immune system health and response to antiretroviral therapy. But CD8 "killer" T-cells also play a role in immune response against HIV and give important information about disease progression.

Initial or serial elevated CD8 counts while on HAART (highly active antiretroviral therapy) or an increase in CD8 counts from HAART initiation may be early warnings for future treatment failure."

 

[heapsreal]

Perhaps an elevated CD8 count hasn't proved to be of much importance outside of HIV treatment/diagnosis?

Cd8 is commonly high in active herpes viruses ebv, cmv etc. So if one is not quite sure ebv is active, a high cd8 may indicate this??

 

[sorin]

Cd8 is commonly high in active herpes viruses ebv, cmv etc. So if one is not quite sure ebv is active, a high cd8 may indicate this??

That's interesting but I am afraid there is a kind of vicious circle. Because CMV, EBV can be active even if IgM is negative and PCR negative? For example I have high IgG but normal IgM and still high Cd8... So what is the conclusion here? Unfortunately, no conclusion. We can make only suppositions... And even if one has active herpes viruses, this may be a side effect of another infection rather than the main cause of the problem.

 

[heapsreal]

That's interesting but I am afraid there is a kind of vicious circle. Because CMV, EBV can be active even if IgM is negative and PCR negative? For example I have high IgG but normal IgM and still high Cd8... So what is the conclusion here? Unfortunately, no conclusion. We can make only suppositions... And even if one has active herpes viruses, this may be a side effect of another infection rather than the main cause of the problem.

Ive mentioned cd8 is commonly high in herpes viruses and i dont say it should be used as a sole test to diagnose ebv cmv etc, but mention it if one has other evidence of a herpes infection, they can use this as further possible evidence. But cd8 could be elevated in any infection. If one has cfs and high cd8 t cell then its worth investigating for a possible infection, not just a one test but maybe a serious of tests over a few months of elevated cd8 t cells and then look for a possible chronic infection.

Im not sure what your aiming at, hopefully the above clarifies my view.

What further tests have you had to investigate why your cd8 t cells are elevated?

 

[heapsreal]

And even if one has active herpes viruses, this may be a side effect of another infection rather than the main cause of the problem.

A side effect?? If you had a herpes infection plus another infection, how would you know its a side effect? Id be more tempted to say its a co infection. In hiv when they get a cmv infection, they dont call it a side effect of hiv, its referred to as a co or secondary infection but they still treat it or the hiv patient could die from cmv or some type of severe chronic disability like going blind.

 

[sorin]

A side effect?? If you had a herpes infection plus another infection, how would you know its a side effect? Id be more tempted to say its a co infection. In hiv when they get a cmv infection, they dont call it a side effect of hiv, its referred to as a co or secondary infection but they still treat it or the hiv patient could die from cmv or some type of severe chronic disability like going blind.

I said "side effect" because that co-infection normally would not appear, but appears because of an immune deficiency caused by the main infection (like HIV or other infection). Maybe I used the wrong term but we actually refer to the same idea.

 

[sorin]

...
What further tests have you had to investigate why your cd8 t cells are elevated?

I started to feel bad in 2010 (very strong flu infection, like mononucleosis) and first symptoms of CFS started in 2012. Two years ago I did the first CD4, CD8 test that showed an inversed ratio and elevated CD8. I repeated the test at each 6 months and the values are pretty much the same. So this is chronic. Then I tested for HSV, EBV, CMV, Borellia. CMV gives very high numbers for IgG but negative IgM. The same with EBV and Borellia. The interpretation was that I had a past infection but no actual infection!!! Which is in contradiction with the chronic reversed CD4/CD8 due to increase in CD8. At this point no other conclusion was drawn by a doctor...

 

[heapsreal]

I started to feel bad in 2010 (very strong flu infection, like mononucleosis) and first symptoms of CFS started in 2012. Two years ago I did the first CD4, CD8 test that showed an inversed ratio and elevated CD8. I repeated the test at each 6 months and the values are pretty much the same. So this is chronic. Then I tested for HSV, EBV, CMV, Borellia. CMV gives very high numbers for IgG but negative IgM. The same with EBV and Borellia. The interpretation was that I had a past infection but no actual infection!!! Which is in contradiction with the chronic reversed CD4/CD8 due to increase in CD8. At this point no other conclusion was drawn by a doctor...

It becomes and educated guess. Medicine can only diagnose a new igm infection or an overt infection with a pcr test or maybe a spinal tap but even then infections are missed.

All i can say is do a treatment trial for different infections you have igg antibodies for. Its really a guessing game, trial and error. I think theres something driving our immunity down especially if herpes viruses are reactivating. Treating them may help?? Lyme is also hard to treat and co infections lime babesia are very hard to test for.

 

[sorin]

@heapsreal I did a 9 months treatment with Valtrex against CMV, HSV. After I have stopped it I felt relatively acceptable (far away from being cured).

 

[heapsreal]

@heapsreal I did a 9 months treatment with Valtrex against CMV, HSV. After I have stopped it I felt relatively acceptable (far away from being cured).

Why i think theres something else driving this disease. Treating cmv and hsv is just peeling a layer back.

Im not saying it would be a cure but interesting to see if they could have better drugs that can increase our nk function and see how cfsers go, seen as though its a common abnormality found. Doesnt seem like the researchers have really consideted it or dont have the technology too??

 

[sorin]

Im not saying it would be a cure but interesting to see if they could have better drugs that can increase our nk function and see how cfsers go, seen as though its a common abnormality found.

Which NK cell test do you say that shows abnormal values for CFS patients? For example, in my report the NK cells CD3-CD16CD56+ is 319 which is normal (the reference interval is 115-669).

 

[heapsreal]

Which NK cell test do you say that shows abnormal values for CFS patients? For example, in my report the NK cells CD3-CD16CD56+ is 319 which is normal (the reference interval is 115-669).

Whats commonly available are nk number tests not function. So lymphocyte sub sets test is just the number of nk cells like cd3 cd56 etc.

Nk function testing isnt common, in australia i only got my testing done when in a research study and not able to get it outside of that setting. It involved nk function test as well as nk dim and nk bright cell function testing. In america there are some labs which people can get nk function testing eg nancy klimas commonly does it.

Its my understanding that the test has to be done within approx 24hrs after the blood draw, so not practical to send blood to a lab that is too far away.

Im not sure where you live but maybe look out for cfs research studies you be apart of and get some free testing which might include nk function testing and other specialty testing not commonly available.

 

[pemone]

What ratio of CD4:CD8 would be suggestive of a possible autoimmune condition? Very few references online do more than give a reference range.