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Puzzled about T-cells

Oct 16, 2004

hello, 30 years old male with HIV for 2 1/2 years taking since the beggining sustiva and trizivir started with >75,000 vl and 61 cd4, a year later 208 vl and 314 cd4 and remained considerably constant until following year undetectable viral load and 289 cd4 then in 3 months vl undetecttable and cd4 215 and three months later or currently undetectable and 196 doctor has not answer as to why my t cell are low and suggested a resistance test but the labs send them back saying is was unable to conclude due to undetectable status so now still puzzled my doctor suggest adding viriad to the regimen to see if my t-cells will go up. I also have HPV and currently on aldara and will be seeing a gastrointerologist for possible HPV infection in the colon...I ask my doctor if the hpv will cause the low t-cell count and responded that is unlikely. please help me here understand more the importance of adding a new medicine and t-cell development.

Response from Dr. Holodniy

This is a situation we see from time to time, but don't have a good answer for. HIV drug resistance would have been a good thought if you had an increase in your viral load. But this is not the case and you need a viral load of about 1,000 to have a resistance test performed. It is unlikely that HPV would be causing this problem. I agree with your doctor about adding or even changing your regimen around. Sometimes we can halt the decline or increase the count with this kind of strategy.

CD4 Dropping on Undetectible Viral Load
T Cell Cloneing

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