Hello Doctor,

i am since 15 months on Therapy Truvada/Viramune. My Numbers since then are VL undetectable, CD4: 231/14% June 09, 348/24% Sept 09, 248/20% Feb 10, 268/19% June10.

My doctor says that my body seems to react slow in terms of Immune response and maybe have settled on a plateau of around 300 CD4. Meds could not do any better than reduce the VL to 0, the CD4 would be up to the body.

So my question would basically be if there is any way or alternative treatment to boost or influence the CD4 count if it does not further increase by itself.

If not, whats the long term projection with a CD4 count of that kind, I am 37 years old no OI, no Hepatite.

Another question i have: Two liver values are increased due to Virmune, Alanine Aminotransferasa is 46 (Reference 5-41) and Gamma Glutamintransferasa is 151 (Reference 10-71). I drink Alcohol maybe once a month. And Hep A,B,C negative. The doctor said its only slightly increased , so no indication to change meds. Would you agree on that or is there any danger in long term with this increase. I take Viramune because i had a history of depression so no Sustiva and KAletra has increased my Triglycerids which are fine with Viramune.

Thanks a lot for your help

Kind Regards M.

You don't indicate what your starting CD4 count and percent was prior to starting HIV treatment, unless the 231/14% was prior to starting. I don't think changing to a different regimen will increase the rate at which your CD4 count increases. You will likely get some further increase CD4 count, but how much is difficult to predict. I agree with your doctor. I would not be concerned about the liver enzyme increase.