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Variations in absolute CD4 cell count

Mar 14, 2010

Dear Dr. Holodniy:

I tested HIV+ in May of 1997 and started antiretrovirals right away. Within six weeks of starting the meds I became undetectable and have remained so ever since. I have also watched my CD4% climb from around 28% to the low 40%'s and my absolute CD4 cell count climb from 280 to the mid-500's to the low-800's (it bounces around from visit to visit).

At my most recent visit this past week I remain undetectable VL and my CD4% is 40% but my absolute CD4 count has gone down to just below 400. My doctor said that (a) since I had been sick previous to the blood draw that this was normal (I had the flu, and honestly I think it was H1N1, about one month before the blood draw, it was the worst flu I ever had, was out of work for a week) and (b) that the CD4% is a more stable indicator of one's immune system integrity than the absolute CD4 count since that can vary from day-to-day or week-to-week similar to some hormone levels.

So my question is, is this true? Do I have anything to worry about with the drop in the absolute CD4 cell count? Is this a possible indicator of the beginning of med regimen failure or something else going on (all other lab work and my exam were normal/unremarkable)or should I just attribute it to the flu/virus I had since my CD4% remains high?

Thanks for your time.

J in NYC

Response from Dr. Holodniy

I agree with your doctor, I would not be concerned.

i started taking atripla in december 28th 2009 and i am not undetectable yet..
what is wrong?

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