Oct 2, 2011
After a year on Truvada + Integrase Inhibitor my VL is Undetectable and CD4s have gone from 400 to an average of 680. I am obviously happy with that. However my CD8s remain high and my CD4/8 percentage averages at 32. Is this likely to improve and if not can you tell me whether this means I am in the chronically inflamed state and what health issues to look out for in the future (cardiovascular, diabetic, for example) or whether this will lead to premature ageing. Thank you in advance.
Response from Dr. Holodniy
Great question. We still consider an elevated CD8 count as a good response to the infection. In many people who start HIV treatment and the virus is brought under control, we see a decline in CD8 count because the stimulus for the elevation has declined. But the devil is in the details. One cannot just look at numbers (although for the most part that is all we have clinically), one has to also look at activation levels of CD8 cells and what they are making (which are still really research tests, and we are not sure what these test results mean). As you know there are now other "inflammatory" complications associated with HIV infection and longer term use of HIV meds. How much of these complications are associated with the virus, the meds, or the underlying genetics (propensity to develop these other medical problems if they didn't have HIV infection) is still actively being studied.
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