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Follow-up: T Cells decreasing but percentage stable after unknown illness
Mar 18, 2012

Hi Dr. McGowan,

I just wanted to follow-up about a question I had to you as it might help others. My specific case is that I have been on meds (Sustiva/Epzicom) for 5+ years. Since then I have been always undetectable and my CD4 count has steadily increasing from 225 to 650 with a CD4% in the 30s. In January of 2011, my CD4 Count was 650 with CD4% of 34. In June 2011, I had an unknown illness for several months that dropped my t-cells by neary half. I was tested for hep a,b,c but my doctor could not find any reason for my chronic fatigue. Since then, my numbers have been as follows:

June 2011: CD4 350 CD4% 35 July 2011 (retest): CD4 409 CD$%: 36 December 2011: CD4: 379, CD4%: 37

Based on your response that I might have something else stimulating my immune system, I went to see another doctor who found that I had h. pylori. I went on the 14 day treatment and within 1 month my fatigue that was constant for 7 months went away. I got my lab results today; my h. pylori has been eradicated and my CD4 jumped 120 points to 505 (35%), although I have my first blip of 126; this concerns me a little but my doctor says I should not worry as this is not uncommon.

Anyway, I just wanted to pass this along. Something as simple and common as h. pylori seemed to be the culprit that caused me lots of misery. Had I not been proactive, I would still be wondering why I feel so bad.

Best regards and thanks for your great advice!

Response from Dr. McGowan

Thank you for the follow-up. Sometimes chronic underlying conditions can go undiagnosed for long time periods unless a directed approach is undertaken. We monitor CD4 counts so closely that we get clues to these conditions more quickly. The same thing would happen to an HIV-uninfected person, but we would not pick it up since we do not test CD4 counts routinely.

Hope you continue to feel well.

Joe



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