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Rate of Progression Question
Jul 16, 2006

My partner has been infected for 2 years and recently started taking medication about 3 months ago when his CD4 count dropped to about 200. He had his first test since taking the meds and his viral load is undetectable but his CD4 only went up to 275.

My partner also has chronic fatigue syndrome and the epstein barr virus which I believe effect the immune system but I was curious to know if with the medication his CD4 count will continue to rise or possibly what the outlook is for his future.

Response from Dr. Sherer

The average response to ART is around 100 CD4 cell rise in the first year, but there is a wide range of responses. Your partner's response is a good one - 75 cells in the first 3 months is fine, and suggests that he may exceed the average.

People with HIV-related opportunistic infections or CD4 cell counts below 200 tend to have lower CD4 cell rises than those who have never had either condition.

Fatigue is a common and vexing problem with HIV, but your partner should continue to talk to his doctor about it. It can be caused by HIV itself, and respond very well to ART; it can be caused by OIs; and it can be caused or aggravated by the ART itself. Multiple trials to address the fatigue are a good idea, often simple trial and error. He should not get discouraged that the ART did not magically resolve it. Sometimes it takes time - and sometimes it is only improved without completely resolving.

Most importantly, he will get the best possible result from his ART if he takes every dose without missing doses.

I urge you and him to talk to his doctor about this response.


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