Falling CD-4 and now not undetectable

Question

I'm 15, born Poz. last four labs I was 630, 580, 487, and now 502. I went from Undetectable to a VL of 620. I'm on Combivir and sustiva. It seems like I'm sick a LOT ( colds, bladder infection, thrush). I feel like everyone tells me everything's "OK" just to keep me happy. I want to know the truth. Am I becoming resistant? are those numbers really good/bad? Why am I always sick? PLEASE answer.

Answer

For someone who is 15, those CD4 counts would be considered in the adult normal range. I suspect your CD4%, which is a more stable number over time, is likely not bouncing around. One viral load blip doesn't not necessarily mean that your virus has developed resistance to the meds. However, a sustained detectable viral load, or one that is increasing might, assuming you are adherent to the regimen as prescribed. Given what your viral load is currently, it would be difficult to get a resistance test because it is too low. Labs require that the viral load be > 1,000 in order to perform the test. Why you may be having symptoms is not clear. Your CD4 count is in the normal range and most people would be relatively asymptomatic from HIV with those counts. Although unlikely, you might ask your doctors about whether you were ever checked for other immune system disorders. There are a number of these that can cause problems resulting in infections in children. Because everyone was focused on the HIV infection in you, some of these conditions would likely not have been tested for.