Sudden drop in CD4/cd8%

Question

Hi, on 9/9/2015 my labs were: cd4 count 1078, cd4% 46.9, cd8 636, cd4/8 ratio 1.7, wbc 10,300, viral load <20 copies, and <1.30 log copies.

On 7/6/2016 my labs were: cd4 count 767, cd4% 33.4, cd8 838, cd4/8 ratio 0.9, wbc 6,300, <20 copies, and <1.30 log copies.

I can't get into my dr for another three weeks and I'm worried about the sudden change. I switched from Atripla to Triumeq due to kidney side effects last May 2015. My kidney labs, GFR, and creatinine levels looks great now (1.51 to 1.34 creatinine and 58 to 66 GFR).

On 9/19/2015 my cd4/8 ratio was 1.7 and it was the same on 6/4/2015 and 1.4 on 4/8/2015. On 4/8/2015 my cd8 absolute was 369. It's now 838 just over a year later. So, my cd8 rose dramatically, my cd4 went down, my wbc went down, and my cd4/8 ratio really dropped.

Should I be worried?

Answer

I would not be concerned, given the HIV viral load remains undetectable. For whatever reason, you had a drop of 4,000 in total WBC between those measurements, and that likely accounts for the drop in CD4 and CD8 cells. Very uncommonly, some people have been found to have reduced WBC using Triumeq.