CD4 keeps going down, but undetectable...why?

[puff0721]

i've been on atripla for about 3 months now and my cd4s keep going down...they are now 124...last month 235 and in June 277...i'm undetectable and don't understand why they keep dropping...anyone have any input on this?

[atlq]

Puff,

Cd4 counts acan be highly variable so I wouldn't panic. How long have you been undetectable? What is your cd4 percentage?...

[puff0721]

hi...i became undetectable last month, so it took me about 2 1/2 months to become undetectable. I know that cd4s can vary, but i didn't expect it to drop so much...i'm at 10%

[atlq]

OK...percentage is always a more reliable indicator of immune function than base cd4 counts....do you know what your percentage was before you started treatment? If it has dropped more than a couple of percent, share you concerns with your doctor. Guidelines suggest that people with under 200 cd4'sor a cd4 percentage under 14 be on prophaxsis for PCP (Bactrim once a day)until your counts rise a bit. I also assume you guys ran a genotype before starting this regimen to make sure you are not resistant to any of the components in Atripla.

Ideally you want a cd4 percentage in the 20's (in - folks it is in the forties). My lowest was 11 and I have normally stayed around 19 over the years.

There is no need to panic. Just bring this up with your doc

[wow1969]

not all doctors agree and not all the research agrees with the percentage being a better indicator .... each doctor has his/her own approach to hiv ... i have found, quickly also, that finding a doctor who has lots of experience with hiv and knows what they are doing is the best thing in finding the best treatment ...

talk to your doctor and i'm sure that you will both find a way to deal with your numbers ... i bet you will be fine

[puff0721]

they did put me on bactrim last week....i think my % was 8 or 9 to begin with and i show no resistance to any meds from the genotype...i've been really really tired for the last week and i've been on generic ritalin 10mg 4x a day for about 2 years now and it doesn't even seem to help.

[atlq]

Wise words, 1969...I amend my advice...though I would still be concerned about PCP prophaxsis until the time those counts come up a bit...And I am sure they will. Atripla is a powerful cocktail. But you just became undetectable, so it takes your immune system time to reconstitute itself...



edited for typo......

[dixieman]

man oh man... cd4's go up and down... the main thing is Viral load and your still undetectable... so it shows its working...

[LatinAlexander]

Well, I understand your panic. But try to relax a little bit (cause stress really hurts your immune system). So considering you just went undetectable, give your body sometime to recover itself. (Try to sleep well, drink a lot of fluids, and eat healthy)

Now, I would talk to my doctor to make sure you have a very close follow-up on those numbers. Like in a month or so. Try to keep some sort of diary , about how you feel, if you happen to have some symptoms of whatever, so you can share those with your doc.

You have achieved a very important step : Getting undetectable. So that is something to help you relief you a little on your worries.

Good luck

Alex

[hankgaguy]

Hmmmm, interesting, but it's best to be undetectable.

I switched to Atripla from Kaletra/Truvada in the middle of July. Got tired of the issues with Kaletra.

At the same time, I gave up smoking and started working out again.

Oddly enough, my CD-4 fell by 40% from 527 to 300, although my % stayed good at 26%.  A lot of that could be due to the fact that I quit smoking, which apparently boosts the CD-4 total counts, but in the long run isn't healthy for you.

I'm hangin' in there with the good news that I'm undetectable and that life is good and different for me these days.