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Consistently low cd4/cd8 ratio
Feb 9, 2014

Hi; I'm a healthy 49 year old, successfully treated with Atripla and its components since my diagnosis in 2004, having been undetectable with an average CD4 count of 700-1100 at 30-33%, from my baseline at diagnosis of 290 and 20%. My concern is that my total cd4/cd8 ratio has generally been off, at last testing 43% with a ratio of .76 I realize this is not uncommon, but this signify low-level viral replication and incomplete control by Atripla and a constant state of immune-based inflammation, a condition now recognized to contribute strongly to a multitude of other disease processes?

Thanks

Response from Dr. Holodniy

Your ratio is relatively good from an HIV standpoint. Given your normal CD4 count, it is likely reduced because of an increased CD8 count, which is a natural response to HIV infection. Markedly increased CD8 counts in HIV infection have been associated with inflammatory conditions perhaps leading to increased risk of cardiovascular disease as an example. The jury is still out as published papers are conflicting about whether this condition is associated with greater chance of low level HIV replication. Unfortunately there is no good intervention strategies to change the ratio through lowering CD8 counts and therefore lowering the risk of possible other diseases.



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