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TCells going down
Oct 4, 2004

I have been on HAART for over a year now. I started out at 175 Tcells ,and after starting, it shot up to 600Tells and my viral load quickly became undetectable. Over the last 6 months it has been slowly declining and is now at 320Tcell. I am viral undetectable, and have had no infections or problems what so ever. I am taking Videx Ec, Epivir, and Sustiva. Should I be nervous yet, and change my drug regimen? How far should I let my Tcells fall, if I remain viral undetectable, before I change my regimen?? Sincerely, Getting Nervous

Response from Dr. Sherer

At higher levels of CD4 cells, the variability of values increases. Test to test variability can occur at up to 30% of the total value, i.e. from 600 to 400 cells, without a meaningful change. As other factors affect absolute CD4 cell numbers, you might ask your doctor if the CD4 percentage also changed during this time, or has it been more constant? If the CD4 percent has not changed more than 3% during this time, it would suggest that these changes are less meangingful.

There is no evidence that changing regimens in the presence of well-suppressed viral loads provides any clinical or immunological benefit. I would not encourage you to consider a regimen change based on this information.

And, of course, I urge you to talk to your doctor about your results and this response.

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