Hi, Dr. Holodniy.

I recently started medication (atripla), after a consistently very high viral load (500k 800k) and all over the map cd4 numbers (250-700) coupled with a constantly decreasing cd4 percentage. Most probable date of infection is a year ago.

4 weeks after starting meds these were my numbers: CD4 600, 19% (up from 350, 13%), VL 2.91 log (down from 5.89 log).

I know the results are very encouraging, and was wondering if they are predictive of a good treatment outcome and whether they are consistent with the probable date of infection or such a cd4 rise is just something that is usually seen in patients that start meds with a high viremia.

Thanks a lot.

There is some data to indicate that your response after 4 weeks is predictive of long term response to treatment. But, this has not been completely worked out. I am not aware of CD4 trajectory being predictive of the date of when infection occurred. Your absolute CD4 count increase is definitely greater than we normally see at one month, but not necessarily the percentage. In addition, the CD4 percent is still low with respect to absolute count. In other words, someone without HIV infection and who has a CD4 count of 600 would normally have a CD4 percent of 30-50%.