Hello Dr Keith. Thanks for your support. I have been in treatment since last february. I started with a VL of 66 k(it got til 172k), 16.5% of CD4 (255). After two months I became undetectable and now my CD4 are around 300 and 23%. I am still undetectable (under 40 copies) But these numbers are still low, don't they? Should I be worry about this? what can I do to improve my numbers? I am on Atripla. All my numbers (liver function) are ok. My linfocites are within the normal range but always low. I always do the test at 7 am in the morning without having breakfast. I really appreciate your guidance...

CD4 counts can be frustratingly variable. CD4 recovery after starting effective antiretroviral therapy is also quite variably. Though most patients see a good CD4 recovery a significant minority (ie 10-25%) dont experience much of a CD4 recovery initially despite good HIV suppression. There are many reasons for that including age (older age then often less CD4 recovery), scarring of lymph nodes, small thymic reserve, genetics, ongoing immune activation, and other factors. I would be patient-sometimes immune recovery can be slow but suppression of HIV replication is a key factor to maximize chances for CD4 increases over time. KH