When will my t-cells go up???

[bubble]

I've been on Kaletra/Truvada for about 13 weeks. Just got bloodwork back yesterday and my VL is still not undetectable but trending down - almost there at 117 from 75,000 when i first started... but my tcells are not going up at all. they actually dropped 20 points which i know is not significant but i would obviously like to see them rising. Doc says it take months for them to rebound after the virus is suppressed. Is this what most people are finding? We live in an age of instant gratification. Why can't I get it from the meds??

[JohnOso]

Bubble,

My doctor told me that when the virus is suppressed, the body's initial reaction is to surge forward with CD4 cells.  Kind of like a car that has the accelerator gunned and the brakes applied simultaneously.  When the brakes are released (virus stopped), then the natural reaction is for the car to take off quickly (CD4 production).

My CD4 count was very, very low when I started HAART, so there was an initial surge (13 to 130's), then by my next draw it was back to 80.  It's trending upward now, but still at a frustratingly slow pace.

The main thing is that you seem to be knocking the virus on it ass (per your VL numbers).  Also remember that the CD4 count may vary at any given moment.  A more stable indicator over time might be the CD4%.

Remember, you're doing what you need to be doing.  Take your meds, live a healthy lifestyle, and don't forget to take care of yourself mentally.  Popping your pills every day is a cakewalk compared to keeping everything else in balance, my friend.

No instant gratification here dude.

John
(who feels your pain)

[bubble]

thanks for the words. i just thought it would happen faster - seems like people who go on meds early are better off these days or at least are able to maintain higer tcells. i will focus on the % next time but don't know what it was actually this time. i know we should all be thankful that we even have meds these days...

[SFscruff]

Greetings from a classic I.N.R. - Immunological Non-Responder.  There's a number of us who have had complete HIV suppression on H.A.A.R.T. but our immune systems have not responded with an outpouring of CD4's.  Medscape.com has a few excellent medical journal articles reporting longitudinal studies looking at I.N.R's and our 'situation.'  My CD4 nadir was 12 in 1998 when I started H.A.A.R.T. and my CD4 count has increased and vacillated, but never has reached over 250. 

In one sense I am fortunate as I haven't had any immune reconstruction syndrome effects, but still, I'm trying hard not to be a numbers-queen and look at a marginal CD4 count as failure.  I started in 1998 with a P.I. based regimen, and once my viral load was completely suppressed a few months later, switched to a reverse transcriptase inhibitor based regimen to keep the P.I. option open down the road.  When I get my quarterly labs done, I try to focus on the Non-Detectible viral load, and just roll my eyes at the low CD4 count.  I stay on PCP prophylaxis even when my CD4s crawl over the 200 mark, because they are sure to drop back down into the danger zone.  I've chosen to not take pharmaceutical interventions to try and increase CD4 counts as I'm a bit leery of inducing my calm immune system to reactivate.

I guess I just feel lucky that I'm keeping my viral load suppressed and if my CD4s increase, well, that's just a little icing on the proverbial cake. 

Good luck and don't get discouraged, easy for me to say, I know...

Darin