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good CD4/increasing VL x5 yrs
Jun 4, 2006

Dear doctor, Been dx for approx 5 yrs. Initial CD4 count was in mid 500's and VL was 57,000. since then CD4 has fluctuated downward approx 150 pts. to 371 as of may 2006. VL however, has rocketed to over 2.5 million in most recent tests. Meds have not helped much. Have gone through 5 genotype/resistance related adjustments in last 18 months. Wondering how my CD4 count can sustain it's self under such high VL numbers, and meds not effective. Any advice would be great. Thanks

Response from Dr. Holodniy

Your case is quite complex if in fact you have undergone those kinds of changes in HIV meds because of the development of HIV drug resistance. Thus, I can only speak globally to the issue. It is quite possible that despite a high viral load and lots of drug resistance, your CD4 count has been maintained because resistance comes at a cost to the virus. In other words, the more resistant a virus is, the less ability it has to make virus copies that can efficiently infect and kill CD4 cells compared to a virus with no resistance.



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