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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
          
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cd4 counts
May 29, 2008

I have been HIV positive now for 4 yrs. Originally I had 158,000 copies and was placed in the hospital for 7 days with pneumonia. I recovered very well and after trial and error I found an awesome treatment. I have been atripla for nearly a year now. I have absolutely no side effects that bother me anyway and i am currently undetectable with <48 copies. Even at my sickest my cd4 never went below 200 but now even thought i have been undetectable for nearly 8 months, my cd4 hasn't really changed much and stays around 450 or so (once it was like 568). What am I doing wrong?? if the copies are going down so low, shouldn't my cd4 be climbing out of the roof ?? I guess I don't understand what the cd4 is or how high it should get ? I am assuming as long as it doesn't go down, I am gonna be ok. I am not worried about dying as I do have a great doctor who has been with me the entire journey, but he uses alot of technical terms to describe cd4 that I just don't understand. I am not stupid by any means, that is just not an area I understand very well. I appreciate any feedback you can give me and thank you very very much for having this site. It was extremely important to me to know that I am not the only one who is dealing with this. These days I am in great condition, mentally and physically, but it took alot of reading and talking with people.

Response from Dr. Henry

Perhaps 20%+ of patients on effective HIV therapy (defined as fully suppressed virus) fail to steadily recover CD4 cells. There are many reasons for this including a small thymus gland, genetic capacity to make extra CD4 cells, ongoing T-cell activation in places like the gut that still can cause T-cell problems even when fully suppressed, severe destruction of the lymph node architecture throughout the body, and other causes. This is a relatively common (often unexplainable in the clinic) phenemenon that is perhaps more common when older or starting with a lower CD4 count. KH



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