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Fallen CD4 Count
May 11, 2008

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?

Response from Dr. Holodniy

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.



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