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gradual decrease of cd4

Jul 14, 2013

Dear Dr Mark thank you for your great support. Iam on medication( stocrin 3TC and AZT) for 8.5 years. I started medication with a very good account of CD4 ( 450). My viral load was not also to high and quickly was undetectable until now. My number of CD4 after the medication went to approximately 850 the time i started the medication. But from that time until now is continuing to decrease. Last year was 280 then was 230 then was 330 then again 280 and recent test is 215. The viral load in undetectable. In my country they do not do persentage. I worry about this result. I have never lost any dose of medication. Iam completely healthy. I know that i asked this question many times to this side but never took any appropriate answer. My WBC is normal ( 6000). Thanks

Response from Dr. Holodniy

It is difficult to understand why your CD4 count would go down so significantly with an undetectable HIV viral load. Your WBC is in the normal range and if your total lymphocyte count has remained stable, then this is likely a real CD4 decline result. A CD4 percent would be helpful here, because if the CD4 percent had declined significantly, then your CD4 count decline is real. We see this on occasion and it is not clear what is going on. In many cases, we switch medications to see whether that will improve the CD4 count, even though the viral load remains undetectable. Sometimes that works and sometimes it doesn't.

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