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Drop in CD4
May 14, 2007
Dear Dr. Daar
After completion of my anti -
TB therapy and cessation of
one ARV my CD4 has dropped
from 501 t0 375. I still continue to take the Triommune. The arv that has been dropped was Didanosin given to balance the effect of the Anti-TB therapy.
What could be the reason for this drop ? My doctor is concerned and has ordered a viral load test. He is mulling over the problem and may go for a new regime. Could this be an
indication that there is resistance building up ?
Is this a normal fluctuation ?
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Response from Dr. Daar
Thank you for your post. Certainly this type of fluctuation could be normal. Knowing whether the CD4 percentage changed would be helpful as will the viral load. In all likelihood if the viral load remains undetectable this is likely to reflect normal variability. Needless to say, if the viral load is detectable it would be ideal if this can be confirmed and a drug resistance test performed in order to design another regimen.
Best,
Eric
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