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Just trying to understand why I'm not above 200 cd4
May 11, 2013

I've been on Atripla for almost three years and my cd4 is still not over 200.. I did start with a very low count of 7 with a cd4 % of 1.8 VL over 200,000.When I found out i was hiv+ I had pneumonia. That was 7/6/2010. I started meds 8/16/2010. Soon after i had bad abdominal pain 8/29/2010 and was hospitalized. They did a biopsy of the lymph nodes in my abdomin. I was diagnosed with MAC and put on a ton of antibiotics. Fast forward to present . I'm no longer on the med for MAC being my cd4 is above a hundred. I have gotten as high as 197 but most recently I've dropped back to 161.. :( I've also been recently been diagnosed with Osteonecrosis in both my ankles making me feel 99 yr old. (I'm only 32)Also since November i been having blood when I wipe after bowel movement . I've had a CT scan and some kind of swab test to check for blood both came back ok. Also have been set up for a stool sample test now. Just want to know why its taking so long to get above the 200 mark?It really scares m e that something is wrong with me.Any input would be greatly appreciated. Anyways i stop now and list my numbers from start to now. Date. VL. Cd4. Cd4% 8/10/10 73000 7 1.8 10/28/10 120. 27 9 1/28/11 130 86 17.2 4/28/11 7700 85 16.9 I guessing vl blip 7/28/11 30 74 14.8 10/24/11 90 116 19.4 1/30/12 <20 143 23.8 4/30/12 < 20 152 25.4 7/30/12 <20 189 23.6 10/30/12 30 158 22.6 1/29/13 <20 197 28.1 4/24/13 <20 161 26.9

Response from Dr. Holodniy

Given where your CD4% is, your CD4 count is actually lower than it should be. In general, someone with a CD4 count of 200 has a CD4% of about 14%. Your CD4% is much higher and your CD4 count should thus be higher. What your numbers tell me is your bone marrow is not working effectively yet to make new cells, and likely a result of advanced HIV infection and MAC infection in the bone marrow. This will likely recover some more over time and I would predict your CD4 count will increase modestly.



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