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CD4 Stagnation

Apr 24, 2011


I have been on Atripla for 9 months.

Initial VL was 25,000 and CD4 was between 187 and 260 when I started treatment. It took not quite 6 months to become undetectable (drastic VL drop initially then tapering to <48), and CD4 rise was initially quite rapid to 365. My last two labs have shown VL still undetectable, and CD4 is hovering right around 350....the percentage is up to around 20%.

I have had no infections or ADI's and am otherwise quite healthy.

I have a few questions, which I have asked my doctor, but always welcome more opinions and information....

Is an initial rise in CD4 followed by a "plateau" common?

What, if anything, could be causing my CD4 to stagnate this low ?

Shouldn't I expect the CD4 to rise higher as long as the VL is undetectable?

What, if anything, can I do to assist my CD4 production (such as supplements, diet, exercise, etc.)?

Thank you very much. I realize these questions have been asked in different forms, but I wanted to ask them exactly as they are in my mind.

Response from Dr. Holodniy

You have had a great response to treatment. The average increase in CD4 count after a year of treatment is between 100-150 CD4 cells. So your response is quite typical. You may see a further, but much smaller increase in CD4 count over time. There is not a lot more you can do to further increase the count over what HIV meds are already doing. But the things you mention are all good for you anyway.

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