I was diagnosed about 3 months ago and went on meds (Truvada, Kaletra, Bactrim & Azithromycin) almost immediately as my VL was 16,000 and my CD4 was 30. My VL is now undetectible and my CD4 has crept up to 50. I've recently had an outbreak of anal warts and cold sores on my lip. I've had some headaches as well, but my Dr believes they are migraines and not indicitive of anything worse just yet. He said I'm most likely experiencing Immune Reconstition Syndrome. As frustrating and upsetting as these side effects are, I guess I'm wondering, can this technically be considered progress? Is my immune system actually improving? Once I'm over 100 or so does my risk for things like this decrease?

It is frustrating that many patients with low CD4 counts when they start ART have more side effects (including much higher rate of immune reconstitution effects) than persons starting at higher CD4 counts. Suppressing the HIV level to undetectable is huge progress and provides some clincial protection on its own. CD4 increases from 30-50 are also noteworthy-sometimes progress is slow as far as immune recovery goes but the higher it inches the more protection a patient has against HIV-related complications. Reaching > 100 is good-hopefully over time you will >> 200. KH