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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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Truvada and Bactrim
Aug 14, 2013

Hello Dr. I am on truvada, bactrim and viramune for one year. I have side effects like persistent headaches and lack of sleep.But what worries me is, my CD4 has never gone up beyond 100 though I eat well and exercise. What would be the cause of a low CD4 that never changes?

Response from Dr. Henry

Recovery of CD4 counts after starting effective HIV medication depends on many factors. The HIV drugs control HIV replication allowing the body to try and produce new CD4 cells without a high rate of destruction which is seen when HIV replication rates are high. CD4 recovery depends on factors including; age, genetics/HLA types, how low the CD4 count gets (100 is on low side0, the amount of scarring in the lymph tissue, the size of the functioning thymus, the amount of ongoing tissue inflammation, bone marrow status and other factors. A frustrating group of patients dont recover good CD4 counts initially-I have seen many patients who took years to reach > 200 and in some cases the CD4 count remained < 200 though many of those patients have still done well health wise. KH



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