Hello, I keep sending these questions but never seen them on the website. This is me again with latest lab results: CD4 rose from 110 to 624 and VL dropped from 8.2 million to 7000 within 2 months. It is kind of unusual from what I can figure out. Within that time I've been taking truvada, norvir and reyataz. I seroconverted some 10 months ago and had severe flu-like symptoms. What complications can I expect from such sudden CD4 increase?

I am glad you are having such a great response. Your viral load was unusually high (not so uncommon in children or with recent infection). Some regimens, especially with an NNRTI or an integrase inhibitor, can have very rapid drops in viral load. We expect a fairly quick early increase in CD4 as the cells are expanded in the tissues followed by a more slow steady increase afterwards. You have had the best of both worlds: a rapid viral load decline and quick early CD4 response. Most people who have symptoms during CD4 increase (immune reconstitution) have lower counts that have generally been low for a while (which gives opportunity for an infection to develop and take hold). Since you recently seroconverted you should do fine and be relatively symptom free.

Best of luck,

Joe