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Hep C and CD4 count
Nov 13, 2000

I am both hiv and HCV positive. When my HIV was detected, my viral load was at 500,000 and my CD4 was at 44. I began combo therapy and within 7 weeks, my viral load became undetectable and my CD4 count began to increase slowly. this was in june 1997. over the past 3 and 1/2 years, my viral load has remained undetectable and my CD4 count continued to rise with each blood test. It maxed out at 297 in Feb 2000. Since then, my CD4 count has steadily decreased with each blood test (But I remain undetectable). My blood counts have been running high in some areas and low in others. with a platelet count that generally hovers in the 60-70 range. I was having extreme fatigue and abdominal pain in the upper right quad. I had a Bone marrow and liver biopsy completed recently, and there was some cirrhosis and fibrosis detected in the liver. Nothing was found amiss in the bone marrow biopsy. Could the Hep C be the cause of the falling CD4 count? My doctor and I are both concerned of some underlying infection that we haven't discovered as of yet.


Response from Dr. Dieterich

Dear Scott,

There could always be another infection, however it sounds as if the HCV is severe enough to explain all of those things. Evidence is mounting that HCV is effecting the course of HIV negatively as well as the other way around.Now if you get treatment for HCV, it is likely that your absolute CD4 count will drop temporarily on treatment, but the percentage will remain the same. That will come back as soon as you finish the interferon. Good luck! DTD

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