In the past when I have gotten a cold, respiratory infection, or a common illness the children I worked with had, my counts would change. My viral load count would go up and my CD4 count would drop. It was never very drastic but enough for my ID specialist to take notice. About three years ago the specialist I had gone to since being diagnosed retired and I was transfered to a new specialist. My old specialist did not seem to be too concerned with my counts reacting this way ,however my new specialist seems to think this is an odd reaction and feels I am not taking my meds. I have tried to explain that if my records were to be reviewed it would show this happens when I get sick. My question is should I be concerned with this reaction and maybe ask if this is a warning sign for becoming resistant to my meds or should I not have a concern until later. I would hate for it to become too late to be concerned. My question comes now because I seem to be getting sick more often and my counts seem to be going a little out of wack more often.

When there is an immune stimulation of some sort (such as when you get sick), it may temporarily activate HIV and cause a "blip" in viral load that is usually temporary. In conjunction with this, your CD4 count may decrease, but your CD4 cell percentage should stay the same. All of these phenomena are not usually of any concern. However, if it is occurring repeatedly and frequently, this may indicate that the level of viral suppression that your current regimen is producing is just good enough to keep your viral load undetectable most times, but you may be at risk of a breakthrough sooner rather than later. It may be worth considering a minor change in your regimen to increase its potency.