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Virus undetectable T-cells still dropping
Feb 18, 2007

I was diagnoised 8 months ago and started treatment due to extremely low T-cells, at the time I was pregnant so I terminated the pregnancy and started treatment. At the beginning my T-cell count was 318. Now it is 6months later and the virus is undetectable but my T-cells have dropped to 306. I take my meds everyday and my doctor is very pleased with the meds and how effective they are working, but I am concerned about the dropping in my T-cells should I be worried?

Response from Dr. Sherer

The good news is that you have had the optimal virologic response to your antiretroviral treatment, i.e. your viral load is fully suppressed below the level of detection. I would urge you to be patient and await the next value; there is usually a 50-100 CD4 cell increase in the first year of treatment, and it may take some time to develop.

Usually after six months of treatment, the CD4 cell count will rise, but there may be other factors that may explain the fact that your CD4 cell count has not increased. Note that your CD4 cell count has not fallen; there is no significant difference between the two counts you described.

You can ask your doctor whether the percentage of CD4 cells changed at all from the first value to the second. The percentage is the percent of the CD4 cells compared to the total lymphocyte count; sometimes the absolute number of CD4 cells will not change, but the percent will show an increase, for example when the total lymphcyte count falls.

Also, you may have had some other effects from the pregnancy and its termination that would cause a temporary blunting of the CD4 cell response.

As above, I urge you to be patient and await the next tests, while you maintain your excellent adherence. The medications are working for you, and you should expect to see a rising CD4 cell count in the next 6 months. I also urge you to talk to your doctor about your concerns.


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