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Atripla and CD 4

Apr 17, 2011

Let me start by thanking you for all of your help in educating us about HIV. I have been HIV+ for 13 yeras, Because my VL was alwayes around 1000 - 5000 and CD 4 did not go below 350 untill october, 2010 my DR did not start me on Atripla untill oct, 2010. after starting Atripla, VL undetectable in 30 days but CD down to 307 and 19% from 16.5% . three months after VL still undetectable CD 4 went up to 330 and 20%. should I be concerened about the slow increase in CD 4

Response from Dr. Frascino


Regarding immune reconstitution (increasing CD4 counts), not everyone responds to antiretroviral therapy the same way. Your Atripla is working well virologically (viral load undetectable). Immunologically CD4 counts are rising, albeit slowly. Your CD4% has shown significant improvement: 16.5% to 19% to 20%. This is very encouraging. I would suggest continuing with your Atripla and routine monitoring of your CD4/CD4% and viral load tests.

The problem with inadequate immune reconstitution in some HIVers is one of the factors that is encouraging us to begin antiretroviral therapy much earlier (CD4 counts of 500 or even above 500).

Good luck.

Dr. Bob

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