I've had an undetectable viral load (<48) for more than 5 months, and my CD4 counts have risen from 150s to 390s after a year on treatment (Atripla). Today's lab showed a CD4 drop from 380s to 280s in one month. Viral load remains undetectable. I don't have any current illnesses or infections. Is it normal for such a big CD4 change in a short time? And overall, which do you think is more important to worry about: CD4 or viral load?

You also need to know what the total white blood cell (WBC) count, and total lymphocyte count, and CD4 percent is. On the face of it, a 100 cell decrease could be significant. However, if the viral load is still undetectable, and the CD4 percent did not change (or decline more than 3 percent), it is probably not clinically significant. Both tests are important. Viral load and CD4 count for continued effectiveness of the regimen, and CD4 count for risk of immune system impairment.