I'm a 43 year old male who began treatment with a CD4 of 199 nearly three years ago. I have had KS, but thankfully, the lesions have all faded and no new ones have appeared since about a year ago through HARRT-only therapy. I've been undetectable since about the first month of treatment and my CD4 percentage has risen from a nadir of about 18 to 24. (It rose three percentage points in the just the last three months, which I take as good news.) All of my other bloodwork is very good. However, my absolute CD4 is still bouncing around between the 300 - 400 level. I'm taking Atripla with absolutely no side effects. I'm a little concerned about a recent study showing frequency for non-AIDS related cancers among HIV'ers with absolute CD4 counts of less than 500.

What's your assessment of my treatment results? Would you ever suggest a change in meds to see if the absolute CD4 might rise? Or is the fact that my percentage is still increasing suggesting that I have not yet reached a CD4 plateau in my therapy? Third, what are you hearing about the IL-7 trial results that seem to work on a different mechanism than the failed IL-2 trial in raising CD4 counts?

Thanks for this excellent service!

I think your treatment results are fabulous. Given your history of KS (another virus induced HIV complication) and the fact you have had no further outbreaks, tells you your immune system is on the road to recovery. You may see a further rise in your counts as well. Preliminary clinical trial data on the use of IL7 demonstrates some promising findings, including significant increases in CD4 and CD8 counts and no serious side effects. One concern from test tube findings in the lab has been that IL7 turns on HIV replication, and would this be a finding in people given IL7. The jury is still out and further studies are necessary to understand the full biologic potential of IL7 administered in HIV infected people.