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Can stress cause a downward trend in CD4 count?

Nov 13, 2005

Hello, doctor. I am on HIV meds. Initially my CD4 count jumped from low 200s to 426 and my viral load went to undetectable. Now, my viral load is still undetectable, but my CD4 count is showing a downward trend. The peak was the 426, then it went down to 366, and at last count, it is 316. The CD4% has dropped, but not as much as the absolute count. I didn't think much of it, until I saw a trend unfold. Could this mean my meds aren't working? Or could it be due to the fact that I am in a new, high stress job with hours that change all the time, causing me not to sleep and eat as well?

Response from Dr. Holodniy

Stress can affect your immune system including your cell counts. You don't indicate what the CD4 percent decline was with these CD4 counts. Also, you might look at the white blood cell (WBC) and total lymphocyte counts. If the CD4 percent is staying relatively the same and these other numbers have declined that may be why your CD4 count has declined in the face of an undetectable viral load.

My cd4 doesnt go up, why?
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