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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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cd4 counts
Feb 21, 2004

not sure where to ask this so i'll try here. i've been on treatment for 5 years, sustiva and combivir. my viral load has been undetectable for 4 1/2 years. i've had only one oportunistic infection in the beginning and almost no side effects, but my t-cells won't go over 300. i exercise, take vitamins and almost never get colds even. why is this?

confused in jersey............

Response from Dr. Henry

A subset of patients do not recover their CD4 counts well despite high level persistent viral suppression. Why that disconnect occurs is not known for many cases. Some studies have shown that CD4 recovery diminishes with age. Other studies have shown that the size of residual thymic tissue is linked to T-cell recovery (T= thymus). When I have patients in yor situation I sometime try a different drug combination (such as a protease inhibitor) to see if that might result in improved T-cell counts (that only works a minority of times), try adding one additional drug (intensify) for 6 months to see if that helps, or consider IL-2 treatment (unknown if the increased CD4 counts actually provides clinical benefit--we are awaiting the results of the SILCAAT and ESPRIT trials). KH

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