I have a question about immune system damage. I was diagnosed late (CD4 in the 60s and V/L off the charts) and remember talk about immune system damage. I was left with the impression that different parts of the immune system can sustain damage that may be irreparable, even as other immune system characteristics improve. I think the comment had to do with losing specific types of immunity.

If this is indeed the case and a rising CD4 tide doesnt lift all boats, what types of irreversible damage is typically observed? (i.e. could the flu be easier to catch, could one lose a previous immunity to an illness like chickenpox, or could past vaccines become ineffective?)

Im well into the 500s now and have never had a defining condition, so not really worried. Just curious.

Many thanks for your reply and all you do.

Thank you for this excellent question. Unfortunately there remains many things we do not completely understand about the immune system and how it is affected by treatment. There certainly is evidence that not all parts of the immune system come back on HIV treatment. That said, while interesting it is not clear how clinically relevant these observations are since the majority of people like you do not appear to get signficant infections related to AIDS. I think you are on track with not being too worried. The most important thing for you to do is eat right, exercise, take care of your mental health and keep taking your antiretroviral medications and being followed by your provider.

I hope that helps. Best, Eric