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Ive had 2 combos but cd4 still low
Nov 22, 2002

Hello Dr. I first found out I had this disease in early 2000. I got PCP, very acute case. We discovered that I was allergic to Bactrim(Sulfa)and to Dapsom. After two weeks I made it, my cd4 then was 17. My ID Dr. put me on the usually starter, azt,3tc and viracept, this was very hard on my body and after about 1 year I couldn't take it. My cd4 did rise to 55. My Dr. switched me to Combavir and Viramune. I stayed on this for a period of several months. My cd4 stayed around 55. I got depressed with the MEDs and what I thought was the lack of Improvement, so I stopped! Here, 8 months later i find myself with a cd4 of 16, another case of very mild PCP and Thrush. Is there hope for me? I've recently regerstered at the USC-radier institute, which is the AIDS/HIV clinic. They seem to be good. My PA wants to start me on the combavir and viramune again, do you think this is wise? Should I have a resistance test? How long does it take for T-cells/cd4 counts to go up? is there a general rule or is everyone different?

Thank you for your time.

I'am sorry Ive hit you with so many questions.

cordially,

JV

Response from Dr. Little

Well - as a general rule, it takes T-cells longer to go up than it takes the viral load to go down. For most people, it will take 3-4 months to see a really good response, but it can take longer. The rate of CD4 recovery may also increase with advancing age (i.e. slower in older people). I always like to suggest that patients follow their CD4% and not CD4 number, since the percentage may change for the better while the absolute number does not really look much different. Given your CD4 cell count, I would strongly urge you to try again and wait it out - unless you have developed drug resistance (which is a concern for 3TC and AZT since you have been on both and I don't know what your viral loads were during this time period), your counts should go up.


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