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drop in cd4 count

Apr 18, 2012

Hello I`m a bit worried about my latest blood tests. They show a quite dramatic drop in the cd 4 count. I am on medicat ion for 1 and a half year now( invirase,combivir and norvir), and my blood tests were like this over time

september,2010 - cd4:402, VL: 800.000, february 2011 - cd4: 669, july 2011 - cd4: 696, VL<50, december 2011 - cd4: 972, VL<50, april 2012 - cd4 641 and still waiting for the VL results

My question is what do you think about the sudden drop in the cd4 count from 972 in december to 641 in april?. I`m a bit scared.I think the drop is very significant since i take my medication correctly. My doctor isn`t very helpful. I`m about to switch doctors.She couldn`t give me any explanation. In adition, i`d like to ask you what do you think about the medication i`m taking.I heard that these drugs are a bit out of use nowadays...



Response from Dr. Young

Hi and thank you for posting.

I don't think that I would characterize your labs as showing a dramatic drop. Since February 2011, your CD4 count has been in the normal range- even your most recent at 641. Indeed, if your lab tests report your CD4 percentages, I'd wager that your percents have been stable or increased in the last measurements.

So long as your viral load remains undetectable, I would not conclude anything other than your medications are continuing to work.

You're correct about your meds, I too notice that you're on an unconventional regimen- where do you live? Outside of the US and western Europe, I would surmise. Combivir (AZT+3TC) has been replaced in many parts of the world with better tolerated once-daily combos such as Truvada or Kivexa. You're taking a outdated boosted protease inhibitor regimen, that has been replaced with others such as ritonavir/lopinavir (Kaletra) in many parts of the world, and here in the US by ritonavir+atazanavir (Reyataz) or ritonavir+darunavir (Prezista).

I hope that's helpful. Please feel free to write back with any additional questions. BY

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