Greetings from the Philippines!

Hi Doc BY,

I just got my CD4 count result today and its down to 73. I also had my viral load two weeks ago and its 47. I am worried because just last April this year my CD4 count was 163 and I would like to ask if its normal to flactuate? I never missed dose and always take my meds religiously. What could be the problem? My HIV specialist told me that its normal and I should not worry since my viral load is very low and I have been on ARV (tenofovir, lamivudine, efav) for almost a year now.

Should I change my meds? Or just continue with my current meds?

I dont know what to do.

Hope to hear from you soon.

Regards,

Rico

Hello again Rico and thanks for your post.

If your viral load is 47, this indicates to me that it's likely undetectable. The most sensitive commercially available HIV viral load test goes down to 48 copies- our in-clinic shorthand for this is to denote "47".

In any event, if you're viral load is very, very low and your adherence without significant issues with side effects, I wouldn't be advising a change in your medications.

As you point out, CD4s do fluctuate considerably and with an undetectable viral load, the changes that you report don't seem too significant. I'd ask you to look at the CD4 percentages during this period- they've probably not changed a lot (a reassuring finding).