Hello,

I have had HIV for about 18 months (I think) and I just got off the phone with the nurse at my doctor's office. She was calling to reschedule my appt. b/c the lab forgot to conduct a viral load but what I am confused about is: 1) why my CD4 count has plateaued and 2) why i have to wait to retake my labs after switching to Atripla. When I was first diagnosed the CD4 was 266 and vl over 100K. The second test was was 539, vl <400. In the 2 or 3 tests since the 2nd test the CD4 has bounced between 435 and 480/CD4%~31% and vl <50. Why isn't my CD4 count going up? I assumed the trend would be consistently upward but that has not been the case. The nurse explained that my body was working on getting the vl to undetectable and then will work on raising the CD4 count. I don't know if that's true though. Also, I am on sus/truv and will switch to Atr at the end of the month. My doctor wants me to wait to get new labs done until I have been on atripla for a month. The nurse said something about their being more truvada in the Atripla pill and that she has noticed that folks on Atripla tend to have a sudden jump in their CD4 counts by like 100 and for that reason they wanted to see my body's response to Atripla. Why? I thought Atripla was the exact same thing as sus/truv.

Lastly, what test do I ask for to see if I have a immunity to Hep A&B to see if the vaccinations I received worked. Every time I ask for them to check for that, they do a Hep antigen test that comes back non-reactive but that's not what I am asking for.

Sorry things appear to be so confusing. Without getting into specifics, since I don't know enough about you to do that, I will try to address some of your questions.

With regards to CD4 cells, they do go up initially and then either gradually increase or level off. Everyone is different and we don't completely understand why some peoples CD4 cells go higher than others. Bottom line, your CD4 cell number is great and maybe higher than some people without HIV. I would not worry about them as much as making sure your viral load remains <50 copies/mL.

You are correct that atripla is the same as truvada and sustiva. I would not expect, nor have I seen much of a change when going from the separate medications to the single pill.

Hepatitis A and B immunity are assessed with antibody, not antigen tests. Hep A IgG and hep B surface antibody positive suggests immunity to both.

Best, Eric