Dr. Henry I have an involved question, or at least it seems involved to me. You have given me good advice before. I started Atripla in April and was on it for about four months. I could not get past the nausea and had lost about 40 pounds. Dr. Brown changed me to Combivir and Kaletra. Compared to Atripla I love this set, but at my last appointment I got very confussed. I am still very confussed. This is what I do not understand: Date,VL,CD4,% 1/7/8,336000,510,na 4/8/8,95000,343,17% 4/11/08 Start Atripla 5/3/8,149,na,na 7/31/8,ND,384,23% 8/1/8, Start new meds 11/6/8,ND,252,23%

She told me it was all good. She said that the 23% being constant was good, but since that time I have been plagued with a severe sinus infection, the stomache flue, and another stomache bug. I am concerned, I do not fully understand. I know she told me I had a decrease in white blood cell count. I lost CD4 count. She told me that less than 12% is considered to be AIDES. My questions are simple I guess: What is normal on the percent thing? Is 252 close to having AIDES? Is there anything I can do to help this get better? I take my meds all the time. I have only missed one dose about three days ago when I thought I would puke them back up. I know she tried to explain this but I am still very confused. Is everything ok, or am I in danger of AIDES?

Hank

The CD4 count bounces around alot from day to day so hard to say much about one or two values in many cases. The CD4 % often easier to follow for trends-yours was stable last 2 measures and viral load is still undetectable. Boosted protease inhibitors like Kaletra generally result in similar or sometimes slightly better CD4 recovery than seen with non nuke RT inhibitors like efavirenz (Atripla). I would say you are doing OK and need to be patient to see what evolves over next several visits. KH