Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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CD 4 TCells
Apr 29, 2008
Dear Dr. First of all you are a special Dr. and human being for me. You give me hope for the future of all hivers. Thanks for your existance. I`m 38 year old, I started truvada and viramune in February 2007. CD4 194, 11% and VL 53.000. Now CD4, 305, 20% and VL indetectable. At first 4 months cd4 grow up of 194 to 305, but after cd4 are still always in 305. It`s normal one year later, CD4 still in 305 cells? With 20% of CD4 I have risc of oportunist infections? Thanks for your answer and i wish lot of health for you. Paulo
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Response from Dr. Frascino
Hello Paulo,
Unfortunately there is no "normal" when it comes to predicting the response to antiretroviral therapy. This is because there are so many variables viral strain, genetics, immune integrity, concurrent infections, medication adherence, etc., etc., etc. What we can say from your response to date is that your current combination of Truvada plus Viramune is showing efficacy, both virologically (HIV plasma viral load dropping from 53,000 to undetectable) and immunologically (CD4 count rising from 194, 11%, to 305, 20%).This is a good response to treatment.
One goal of antiretroviral therapy is to drive plasma HIV viral load to undetectable levels. Your combination has accomplished this. The degree of immune reconstitution one gets after the viral load is suppressed varies greatly from person to person.
Regarding opportunistic-infection risk, this decreases dramatically when the CD4 count increases above 200 (14%). Consequently your risk has significantly decreased since beginning treatment. At this point most HIV specialists would advise you continue on your same regimen and continue to monitor your HIV plasma viral load and CD4 count every three months. If the viral load goes up, resistance tests (genotype and phenotype) should be obtained and a new regimen considered based on those results. You can read much more about HIV management issues in the archives and on related links.
Be well. Stay well.
Dr. Bob
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