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Undectable with low T-4 count
Apr 22, 2007

I have been living with HIV for over 20 years. A couple of years ago my doctors discovered I have HIV 1 & HIV 2 all at the same time in my body. Now my question to you is how can I be undectectable and still have a low T-4 count of 285? This is a puzzle even for my doctors as they can't figure it out.

Response from Dr. Young

Thank you for your post.

We field this unusual question about every month-- there is a common misconception that an undetectable viral load means no virus and no disease. For the majority of cases with untreated, undectable virus, the rate of disease progression is very much slowed. This does not mean that in every case that CD4 cells will not decline. It would be important to ascertain if you really do have HIV infection- we'll do repeat antibody and DNA PCR testing to confirm.

Indeed, to this point, I've got a couple of patients just like you (well, without HIV2) who had slowly declining CD4s despite having undetectable viral loads. Finally, we started antiretroviral treatment (still with undetectable viral loads) and noted a very nice (and typical) increase in CD4 cell levels. These cases illustrate the point that HIV was still causing problems and treatment of HIV restored CD4 counts.

Hope this helps. BY

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