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CD4 Going Down But Still Undetectable
Jan 2, 2015

Hello Dr. Young

I have been on ATRVs (Viraday) for 3 years.. Doing great at the begining.. My VL got to undetectable lavels (<25) and my CD4 went from 350 to 600, so far so good. But this last year.. My VL remains <25, but CD4 count have been getting down from 650.. to around 350 and 250 the last test..My CD4% has always been around 20%. I'm a little bit worried about this..does that mean a regimen failure or toxicity? I really dont understand why My WBC has been going down.. I feel great.. never had a OI... Hope you guide me on what can I do.. thanks in advance. Ronny from Venezuela

Response from Dr. Young

Hello Ronny and thanks for posting from Venezuela.

Sorry for the late reply.

If your CD4 percentage is stable and viral load undetectable, then I would have much less concern about any changes in your absolute CD4 count.

Do know that a CD4% of 15 is equivalent (on average) to a absolute CD4 of 200; 20% would predict an absolute count of about 300. This estimate correlates quite well with your past two lab tests.

Indeed, if your WBC count has been declining, it's actually possible that it was elevated in the past, giving you a relatively elevated absolute CD4 count, while keeping the percentage constant.

Overall, based on what you've described, I'm not concerned with your labs.

I hope that helps, BY

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