Hi Doc, thanks for taking the time to answer all these questions - you have made my life definitely better for having read this section.

My issue is with my CD4 count. I have been on Sustiva and Truvada for the past 2 years. My CD4 climbed from lows of 90 up to 400, while my VL has been undetectable (with a test with resolution of down to 400 copies)or very low 111 - 97 - 64 the last three lab results. However my last labs returned CD4 count of 142. The odd thing is, everything from VL to liver functions to CD4% (which is up to 20% from 5%) seems fine - just my CD4 count. What could this be? Since my VL is still around 50 or so, I don't think it is getting out of control yet, but I am worried!

Thanks again.

Given the general very low viral loads, increasing CD4%, and much higher CD4 counts in the past, I think this CD4 count is unlikely to be real. I think I would just repeat it and it will likely be back up again on the next test. However, I am just a bit concerned though that the viral load is really not "undetectable" (i.e. < 50 copies/mL) consistently. Although these low detectable results are likely to be lab test variation, and not a failure in your regimen, it bears some watching.