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CD4 Slight decrease with Undetectable VL?

Apr 4, 2010


I was Dx'd in '08 with CD4 ~190, then started HAART (Kaletra (twice daily) + Kivexa). I started Rx. relatively early as my CD4 dropped right after being infected and never spiked.

My VL went quickly to undetectable and my CD4 rose every three months from 190, 270, 350, 420, and then I didn't have testing done for 5 months. I just found out that my CD4 is at 400 now. I am confused as to why it didn't increase but actually dropped 20? I know this isn't a significant difference, and likely fits into the margin of error on most lab tests (<10%). I guess I am concerned that although I sustain an undetectable VL my CD4 will continue to decrease regardless.

Does this make sense seeing how I saw some fair gains already? Would the pattern reverse or is this just a blip? I am not sick and my physical health is excellent (eat well, take multivitamin and workout 4 times/week and run.

I also need to mention that I had an influenza vaccine within the 2-week period of blood work. Could this have affected the drop within a 2 week period of having the blood work?

Please let me know if this is something to be concerned about. I think that I am experiencing a disproportionate amount of stress over this.

Thank you for you time and consideration.

Response from Dr. Holodniy

I would not be concerned at all with that minimal decline in CD4 count, and yes, is likely within assay variation. You have had a fabulous response to HIV treatment. Your CD4 count has more than doubled, which is better than what is typically seen in most clinical trials. You may see a further but slower increase in CD4 count, but again, nothing to worry about. Just keep doing what you are doing.

Good Numbers except no neutrophils?!? Should I be worried?

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