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one year on. hows it going?
Feb 19, 2007

Hello

I was diagnosed in Feb 06 VL >100,000 CD4 136 12%. After resistence testing started Sustiva/Truvada in March 06 @ VL >100,000 CD4 220 17%. April 06 VL 1600 CD4 330 19%; June 06 VL 300 CD4 300 18%; July 06 VL 200 CD4 226 19%; Aug 06 VL <50 CD4 336 17%; Oct 06 VL 150 CD4 370 15%; Nov 06 VL <40 CD4 440 18%; Jan 07 VL <40 CD4 280 20%. OK now my questions, obviously my VL took slightly longer than normal to fully suppress do you think that this has been a factor in my virtual non movement in CD4/%. I find the CD4/% slightly worrying and very disappointing. How do you view the numbers one year on. I am 100% adherent, have no side effects from meds, had developed KS which has shown good improvement, and no thrush, weight loss since April 06. So physically I m told I m great, good liver kidney function, low cholestral etc. But find it difficult not to concentrate on what I consider a low CD4 when I read of others with huge numbers. Any advice appreciated. Oh and I m 39 by the way and dont smoke. United Kingdom.

Response from Dr. Sherer

You are certainly doing better than your statement of 'virtual non-movement in CD4 #/% would suggest.

The average increase in CD4 count in a year is 100 cells; yours increased by 304 cells from Feb to Nov, and from 12% to 20% from Feb to Jan. These are good outcomes.

I appreciate that you have seen some variability in the degree of rise in the absolute CD4 count, with the latest absolute number 280 cells/ml, but note that the CD4 % with that value was 20%, which was significantly above your baseline percentage of 12%.

My advice: Be patient, all of these trends are positive. Continue with the excellent 100% adherence, as this is the one issue that you can control. And, of course, talk to your doctor about your concerns and this answer.


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