|Fuzion to Raise cd4?
May 9, 2004
I have a couple different questions. I was diagnosed 1 1/2 yrs. ago. I have been on kaletra, combiver and bactrim since diagnosis. My cd4 has never risen above 100 in all this time, even though my VL has remained undetectable. Until now. Last test showed VL at 75. What is considered undetectable? Should I be on more antibiotics besides the bactrim to prevent OI's? Also, would Fuzion be a good option to consider to increase the cd4? Shouldn't doctor be doing more intense testing to find reason for cd4 so low? At what point, how long should you wait, until you can say that the cd4 is not going to increase? Dr. said if cd4 is very low when diagnosed, that the low number indicates that cd4 will unlikely increase ever. Also, I have tingling, burning, and pain in feet. Hands always hot too. Is this neuropathy? Thanks for your time. I hope you can answer my questions, since I can't seem to get my doctor to do anything other than test for VL and CD4 count.
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| Response from Dr. Pierone
Hello and thanks for posting. A viral load of <75 is considered undetectable for most commercial labs. It is good news that you have been undetectable but I appreciate that the lack of a robust CD4 increase must be frustrating. One idea that you might consider is to jettison the AZT and substitute another medication such as Viread. AZT can cause bone marrow toxicity and may blunt the expected CD4 increase. A recent study was done that compared abacavir (Ziagen) to AZT (zidovudine, Retrovir) in treatment nave patients. Both groups received 3TC (Epivir) and Sustiva in this trial. The virologic response to therapy in the groups was similar, but the AZT group did not increase their CD4 counts as much as the Ziagen group. This finding may be relevant to your situation.
The burning, tingling, and pain in your feet almost certainly represent neuropathy and this may be another reason to change out the AZT (although 3TC can also contribute to this problem as well). Let us know what you and your clinician decide to do. Best of luck and keep stay in touch.
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