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low cd4
Dec 8, 2007

My cd4 count has dropped to 124 even though my viral is undetectable. Should I be concerned? What should I do? Is there a way to safely increase my cd4 count?

Response from Dr. Daar

Thank you for your posting. My response does assume that you are HIV-infected. In any event, this question certainly comes up a great deal.

Without knowing more about how long you have been on therapy and where your CD4 count started it is hard to directly answer your question. However, I encourage you to talk to your provider about these issues and whether it might be anticipated that the CD4 count may slowly increase over time or if they are indeed going down. Similarly, a careful review of CD4% might be informative.

If the CD4 cells are not going up or are going down it will be important to review all medications to make sure none could be contributing. Other things to consider include co-infection, such as with HTLV, HIV-2 or HCV. As far as what can be done, no one really knows. Occasionally changes in therapy help. Others talk about the potential role of drugs like IL-2, although it is not clear there are clinical benefits associated with the CD4 cell increase that occurs with this treatment and it is expensive with significant side effects. The good news is that the majority of patients with undetectable viral load on therapy do very well regardless of how high their CD4 cells go.

Best, Eric


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