Hello Doc

Would like to hear what you think about my HAART. Was diagnosed Oct/97 with a VL >800,000 with T's coming in at 50. Started CRIX/AZT/3TC, I am also on SEPTRA, ACYCLOVIR, RIFABUTIN, DIFLUCAN, AMITRIPTALINE and lots of Imodium with B12/Testosterone shots twice a month. From the 3 month mark my VL has been undetectable <500 but on my last round of blood work, here in Toronto all the labs are now using one of the new arrays with readings down to 50 and I am still undetectable. My T's are a bit different, at 3 months T's were up to 270, at 6 down to 170, at 9 up to 220, with the last round, T's are now coming in at 140. My Doc is still happy with my numbers and tells me not to be too concern about the T's, since my VL is still very good. The only thing, with my T's still low, I should stay on all the OI drugs. I have asked him, what am I doing wrong?, and he says nothing! He believes that my T's will take a bit longer to start a real come back, and that they are leveling off at a more realistic level since being so low. The only OI that I have had is, Esophageal candidiasis when I was diagnosed, also had a lot of wasting, in Oct/97 was down to 95lb (normal weight was around 125) June 98 was up to 170 (with the help of megace) now at a much better weight of 140.

What do you think???

Many Thanks..

You have indeed had a terrific response! A current dilemma is whether to use only viral load or the combination with T cells to assess long term antiviral effects. I would be curious to know what the T cell percentages were with those actual numbers. I found that the actual number can vary depending on the total white blood cell count, but the percentage is a more stable number over time. I agree with your doctor. At this point, I would hold the course. If a further reduction in both absolute and percentage of T cells occurs, you may want to consider modifying the regimen. Because of the very low t cell count you had before starting therapy, it can take a long time to build them up. For now, all those prophylaxis agents have to stay.

MH