Hello Dr. Young, the CD4 is rising but what can be done to be so sure where there is no viral load and resistance tests to perform for lack of resources to check antiretrovirals are faring well in the fight against the virus?

Thank you for your post.

In many parts of the world, viral load tests (and certainly resistance testing) are not available. In such settings, we have to use other markers of treatment success.

As you point out, a rising CD4 count (or percentage) is usually a very sensitive marker of success- at least for the first years of treatment. I'll also point out that clinical symptoms (or improvement, thereof) or wieght gain are useful measures of things going the right way.

Short of these markers, we'll have to continue to work to make viral load testing more universally available.

In your case, if you're feeling well and your CD4 count is rising, I'd be happy with the progress. Continue to maintain the adherence, this should ensure long-term success.

I hope this helps, BY