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Low CD4s after 2 years on Meds
Dec 19, 2007


I've been on meds (Epzicom,Novir, lexiva) for the last 2 years. I started with CD4 240, 20%, VL 16,000. My VL went undetactable within weeks. But my CD4's have been around 27-30%, 330-400 for the whole 2 years on medication.(currently 27%, 375) It doen't seem to go up like I see on this board with other people. My doc says the HIV is supressed and there are no other infections. He stated that we don't know what my CD4 were before the HIV infection and therefore a lower CD4 level might be normal for me. Do you think I still have a realistic chance for my numbers to go up? Also, what does it really mean to live with such low numbers in the long run? Will I be more likely to develop cancer and other diseases?

Thanks for your help. :o)

Response from Dr. Pierone

Hello, and thanks for posting.

Yes, there is a realistic expectation that your CD4+ lymphocyte count will increase. The average increase is about 200 after 2 years and then about 30 cells per year thereafter. So you appear to be on track. Clearly, the trajectory of CD4+ lymphocyte count recovery slows after the initial year one/two burst. Most people with counts in the 300 to 400 range lead normal lives and have a very low rate of opportunistic infections. The main cancer related risks which are higher in people living with HIV infection are lymphoma, anal squamous cell carcinoma, cervical cancer (females), and lung cancer for smokers.

Looking at the long-term picture chances are good that your CD4+ lymphocyte count will be over 500 in 4 to 5 years. Best of luck!

Sustiva v. Viramune
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