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Will my CD4 % get to normal level?

Nov 6, 2000

Dear Doctor, thanks a lot for your excellent job. I am following the Body forum since I was diagnosed with AIDS. PCP with CD4 of 42 and VL of 82 K in August 1998. I had no knowledge about my illness because I was never tested before even I am gay and was having occasionally risky contacts. I was most of the time healthy except for some mild allergies and thrush that happens more recently a year before the diagnosis.

I started in September 1998 immediately with HAART after the successful PCP treatment. My CD4 was 18 and VL 14 K which went up to 126 CD4 and went down to 205 copies of VL after 5 weeks of HAART. December 1998 CD4 - 119 and VL of 61 copies. March 1999 CD4 of 143 and VL undetectable (4 copies) in which the level of undetectability in our Lab is 7 copies/ml. My results were very good in which my CD4 continuously went up and was in the 300's level this year and the VL was most of the time under 7 copies this year. My last result as of 16 of October CD4 352 and VL 52 copies - now detectable which does not bother me much, it could just be a blip and I had a mild thrush during that time.

I am satisfied with the results and also with my HAART therapy. I started with Viracept, D4T, DDl but after 6 months I changed the D pills to Combivir because of neuropathy. Aside from the mild side effects which boders me less, I am most of the time fit and still work 100%. Do some sport and I even win some tennis matches against player who are younger and better classified and HIV negative. I have high total cholesterin 7.5 mmol/l and 2.6 mmol/l triglyceride in my last test besides I am taking Selipran. One of my problems is the RBC which is most of the time below 4 million cells, the last was 3.8 million. My doctor says it does not matter because my haemoglobin is normal, between 13.2 at the lowest and 14.7 g/dl at highest. My question is - could this be the cause of my dizziness and light fatigue which I don't consider because as I told you I could still play competitive tennis at regional level and still have a 100% job as a nurse in a geriatric hospital.

My other questions are: because I was never tested before, could it be that I had always a low VL base and that was the reason that I never noticed about my illness? Could it be that I have HIV more than 10 years based on the numbers of my CD4 at the diagnosis point? By the way I have a 350's level of CD4 but the % is only 12%. Will my CD4 % get ever to normal level and that means my CD4 could reach the 700's level?

Thank you very much, your forum is really great. I hope my questions are not complicated. I am writing from Switzerland and I am 45 years old.

Response from Dr. Holodniy

In enjoyed visiting your country during the AIDS conference in 1998. Your RBC count is lowered because of the AZT in the combivir. Your hemoglobin and hematocrit are essentially in the normal range. It would be unlikely that your fatigue would be the result of this minimal decrease in those numbers. Although it is possible, it is unlikely that your percentage and absolute number will ever get back to the "normal" range. But you have recovered 50% or better of your immune system, which means that your risk of serious infection is very small. It is impossible to know when you may have been infected.


Antibiotics, infections and viral load

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