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CD4 count not rising
Feb 19, 2012

without any real symptoms I tested Positive for HIV then found out my CD4 count was 12... I started on Atripla in September after on month my VL dropped from 91000 to 93 my CD4 was 17 still no illness last week my VL was undetectable but my CD4 is 14 and my wbc is also low . Is my doctor missing anything? I'm interested in a second opinion I don't mind sharing my medical history...

Response from Dr. Young

Hello and thanks for posting.

Sound like you're on a good pathway. An undetectable HIV RNA (viral load) is the first and necessary step in gaining back your health. Viral loads drop very rapidly once treatment is started. CD4s on the other hand take time to recover- as treatment really simply lets the immune system recover from the HIV-related injury.

Yes, you've had only limited improvement in the absolute CD4 count; this is one of several measures that I use to assess health improvement. First, how do you feel? Has your energy, appetite or weight improved since starting? If so, this would be indicative of very significant improvemenet. Second, from a lab perspective, has your CD4 percentages improved? Percentages often will reveal steady improvement even when absolute counts vary from day to day. Conversely, are there other lab abnormalities, such as low white or red blood cell counts, that might indicate another process that is slowing your CD4. Could it be that you're taking other medications that are causing low blood cell counts?

It's a long list; one worth discussing with your doctor, to be certain. Overall though, I'd be reassured if your viral load is undetectable and you're feeling well.

Please feel free to write back, BY



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