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Undetectable viral load but zero cd4 count - 3 years on
Dec 15, 2013

Hi doctor

My partner and I were diagnosed nearly 9 years ago, my partner for the first 5 years was very healthy with a high cd4 count. About 4 years ago his cd4 count started to decline at a very fast rate, so he was started on medications, over the next 12 months the doctors seen no increase and at the end of the year his cd4 count was zero so he was referred to the main hospital in our city. They have since investigated and done so many tests to find out why his cd4 count is zero but they can not find anything, over the last 3 years they have repeated lots of tests and they are baffled. This year he did have a bad case of shingles and was hospitalised, but made a full recovery. His medical notes have been sent to many HIV doctors and everyone is baffled on why his cd4 count is not rising, today his viral load is still undetectable but a zero cd4 count. Over the last few years they have swapped and changed his medications to see if there was toxicity and nothing is increasing his cd4 count. More recently when he has been to the hospital, they seem really unconcerned , my question is, have you ever come across this in America (we are in the UK) and should I be worried, I feel like a pest now when I have been with him at appointments as I get anxious but they really say they can't understand what is going on and he is healthy. Any comments would be appreciated.

Thanks

Response from Dr. Holodniy

I have not seen a case such as you describe. There are many excellent HIV doctors in the UK, so it must be a difficult case to solve. I would be curious to know what the HIV viral load, and CD4 count and percent was when he started HIV meds. Are the other white blood cell counts also affected (i.e., neutrophil count, etc)? Has a bone marrow biopsy been performed, and if so, what were the results? What is the CD8 count and percent or is that undetectable as well?



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