sudden drop in cd4 count very worried

Question

hi i am a 26 yr old positive female who has been on sustiva & truvada for over a year. since being on these meds my viral load went from hundreds of thousands to undetectable in a couple of months & my cd4 was over 200 & has risen to 800. two months ago when i went to my clinic for my 3 months check up my vl is still undetectable but my cd4 fell to 400 i was told to come back in 3 months as usual which is at the end of this month. i am very worried about this as i feel great very well indeed. any feedback to what may have caused this drop in cd4 would be great & do you think it could be treatment failure? thanks

Answer

Thanks for your post.

If your viral load has remained undetectable, then I wouldn't be too concerned-- especially since your otherwise feeling well. This means that minimally, you have no evidence of clinical or virological failure of treatment.

CD4 counts vary so much from time to time that it can be easy to get wrapped up in these variations. I'll tell my patients to look at the CD4 percentages whenever this question arises- more often than not you'll not see such large changes. If so, then the decrease in the absolute count is almost always of no real significance (other than cause the stress meter to go up).

Hope this is helpful. BY