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CD4 cells plateued ?
May 31, 2002

Dear Dr. Cohen,.. I have been on meds for one year , during that time I took a two week break from Jan. 1 thru Jan 14 th of 2002 because of money problems at the time;.. My question to you is even though my VL has remained undetectable my cd4 t cells have seemed to have plateued they have remained at any where from 325 to 338 and then back to 330 , ..will they ever reach 500 cd4 count ? When I was initially detected back in March of 2001 my cd4 count was only 117 and my vl was 375,000 so I guess you could say that I have made a major improvement. oh one other thing I have never had any aids related diseases or OI. thank you for taking your valuable time to answer.

Response from Dr. Cohen

So, in one year your Cd4 count tripled - from about 115 to about 345 - and you wanna know when they'll get to 500? Patience...

It appears that you have had a very impressive response to meds. A major improvement as you say. Since in many studies, the average increase in counts is not as dramatic as what you have had. A 200 cell increase in one year, especially when starting from nearly 100 cells, is actually better than average. And since you have ongoing viral suppression - to I assume <50 copies? - then your counts should continue to increase over time. How long it'll take to get to 500 is hard to say, but with continued suppression, your immune system will continue to do what it has already done - recover and repair the damage that was done in the past. One factor you don't mention is age - since younger people can have more Cd4 recovery than older -- and sadly, this change in CD4 count recovery seems to start somewhere over the 30 year old point... nonetheless in time, your counts should continue to increase.

And besides, a count of 350 is protective and excellent enough to prevent most anything HIV related - so even though you want a higher count - this one can do the job for you!

Hope that helps.

Is my drug combination appropriate?
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