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CD4 up and down

Jul 19, 2009

Dear Dr,

My friend is on the second line drug regime(PI) for about 1 year. When he changed from first drug regime to second durg regim, his CD4 was 50. And after six months on PI, his CD4 was increasing to 384 but after another 6 months, his CD4 is falling down from 384 to 246. Why is it drop down after 1 year treatment?Do you think it is the signal of treatment failure or drug resistant as he used to resistant with first line drug regime? However, his health now is better than last six months but he is working very hard under stress environment. DO you think stress can make his CD4 drop down? What can we do to increase his CD4? as he already in the second line of drug regime.How many years he can live if the second line of drug regime fail again?

Response from Dr. Holodniy

YOu don't indicate what the HIV viral load levels have been during this time. Also, what the CD4 percent is, which is a much more stable number over time, as the CD4 count can fluctuate significantly. Stress could make the count go down, but it is usually temporary. People can live a normal life for many years maintaining a second line regimen.

cd4 & RNA levels
Viral Load

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