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CD4=0 VL350,000 Jan 2005
Aug 6, 2006

Hi Dr. Pierone

While I check the website every once in awhile now I thought I should let you and everyone know the benefits of HAART.

January 2005 I was diagnosed and my first report read CD4=0 VL= 350,000

At that time I was scared and reluctant and did not know what to do or what to expect.

As of June 16, 2006 after sticking to my regime of Sustiva and combivir(one pill in the am and two before bed) And pentamidine aerosol for prophlaxis as I am allergic to Bactrim

I a happy to report that I still have no side effects and my count is CD4=220 VL=undetectable and percentage= 32%

Quite amazing I think compared to where I was a year and a half ago.

I have also gained weight that I am not happy about but my specialist insists it is not medication related and it is the simple matter of calories in and not enough out:(

I am playing baseball and obviously have to pick up the pace with my two dogs when we are on a walk.

So thanks again for all that you do and answering my posts when I needed it the most.

And of course one you think it is possible if I keep this up that there is a chance my CD could recover to 500 at least? My specialist has said not likely but have you seen it happen before even if rare?

Thanks again, Canuck

Response from Dr. Pierone

It's great to hear from you!

I remember your original posts and am glad to hear that things are going so well. Long-term observational studies show that CD4 counts continue to increase in response to viral suppression from HAART, but the pace of recovery slows down after the first year. I have seen patients recover from <20 CD4 cells to over 500 CD4 cells, but it may take a number of years for this to evolve. Since we know that the long-term trend is up, there is no reason to believe that in 5 to 10 years your counts won't be above 500.

This is not guaranteed of course and some people seem to reach a plateau of CD4 counts even with complete viral suppression on HAART. The specific antiretroviral medications may be important though a recent study showed better CD4 count recovery with Viread compared to AZT. The differences were presumably related to the greater risk of mitochondrial toxicity and bone marrow depression with AZT. In light of this study it is common to see proactive switches from AZT to Viread and this is a strategy that you should plan to discuss with your doctor.

Thanks for the update and continue to keep us informed.

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