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CD4 Dropping with Undetectable VL
Apr 15, 2004

I have been on HAART for about 5 years. Currently, Viread+Ziagen+Viramune+3tc. Always had undetectable VL, except for a brief period 3 years ago. When I started I had CD4 of about 1,000. They continually dropped and stayed around 600 for the last two years. However, the last three tests (3 months apart each) CD4 was 590, 485 and now 440. I remember my doctor telling me that he thought I would stay at around 600 indefinetly because they didn't seem to go up over time. What could be the reason for the drop in CD4. Should I be concerned or consider switching treatment? Are there things I can be doing in addition to treatment to try to get CD4 counts up? Thank you

Response from Dr. Lee

HIV is not the only thing that impacts the total CD4 count. The absolute number of the CD4 is calculated from the percentage of CD4 cells and the total lymphocyte count which is a percentage of the total white cell count. Sometimes it is more useful to look at the CD4% rather than the absolute number.

If your VL is not detectable, I would not recommend considering a change or switch in treatment.

Overall, your levels are still good. I suggest you talk to your doctor about your worries and see if the percents are stable. If so, there isn't anything to be concerned about with the counts.

Be well.



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