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Part 2 to question on stagant CD 4 or slow increase in CD 4 cells over a few years.

Mar 4, 2012

Today question: Sir, I have been taking Truvuda and Efavirenz on a regular basis prescript by my doctor since my diagnose in 2009. The first time when I was down with a sereve flu, the hospital tested my CD 4 and it was only 132 in total. They also found some infections on the end of my rectum. My doctor said that when I begin taking the HIV medications, the infected areas will be healed. Now, I don't bleed unnecesssary when I passed bowels. I do understanf that whenever I caught a flu, my CD 4 will drop. At present, it ranges between 281 to 316 in total count. My viral load test was done annually and certified alright and had shown less than 40 copies as informed by my doctor that I am on the safe side. Now, my question is.......I understand that from my doctor that some people like myself have immulogical failure meaning the body cannot recover the CD 4 faster due to late testing and diagnoses. If my CD 4 counts did not rise up to the desire level of between or at least 500 counts, will I die ? This is scary but I am not giving up on the medications and want to stay alive till the end. I am aware that I cannot afford to catch another HIV strain from somebody and vice versa cannot infect another person with no HIV. Thks !

Previous question: stagant CD 4 or slow increase in CD 4 cells over a few years. Feb 26, 2012

could you let me know what if my CD4 still hangs around between 200 plus to 300 plus in over 5 years or more but never reaches 400 which has to meet the average of 500 to be on the safe side ? Does it mean that my body will wear out and then I will die sooner ?

Response from Dr. Holodniy If you are on HIV treatment and your viral load is undetectable, and you maintain CD4 counts between 200-300, then you are still at risk, although at a reduced level, for HIV associated complications. The risk is still greater at 200-300, then it is at 400-500 or > 500. However, part of the equation is whether you already have underlying other medical conditions or not, age, and your underlying genetics.

Response from Dr. Holodniy

Again on average, the risk of progression is greater with lower CD4 counts. However, everyone comes to HIV infection differently, and so, it is very difficult to offer individual predictions because of different viruses, underlying immune systems and other ongoing medical issues. Yes, you are likely on the safe side, and also likely have a disconnect in immune recovery. You need to keep taking your HIV meds, maintain an undetectable viral load, and make sure all your vaccinations are up-to-date. I would keep doing what you are doing, living a healthy lifestyle and you'll be fine.

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