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Troublesome CD4 Counts
Feb 14, 2001

Dr. Thanks again for all your help. Brief history: I have been on HAART (Sustiva and Combivir) since I was diagnosed 2-99. At the time of diagnosis my VL = 51,000 and CD4 = about 190. Aside from 2 blips (up to about 200 VL), I have remained undetectable and overall happy with my regimen. My sluggish CD4 counts have been a bit bothersome to me, but at least I was seeing an upward trend in CD4 percentage - until now. In November 2000 I was undetectable and my CD4 made it all the way up to 29, from a one-time low of 14. However my last tests (1-30-2001) have shown a slight increase in VL to 146 and a small CD4 decline from 325 to 264. Furthermore my CD4 has dropped to 22. A 7 decrease. Needless to say, this has me worried. In addition, there was a stupid incident of possible re-exposure. My doc said he is not that worried and doesn't recommend a change just yet. He wants to retest in 1 month. Overall I take care of myself. I eat right, take vitamins and work out daily. Should I be concerned? Would you recommend resistance testing now? If so, would you prefer one over another? Should I consider a change in regimens?

Response from Dr. Holodniy

I agree with your doctor, repeat and reevaluate. Your viral load is too low to do resistance testing. In general, viral loads need to be >1000 in order to perform the test. MH


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