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Undetectable with Declining CD4s -- Any Guidance?

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--- Quote from: weasel on May 09, 2013, 02:49:14 PM ---   I did not mean to hijack  your post !!!!

--- End quote ---

No worries at all -- I didn't feel like you were hijacking.  It certainly is helpful to hear other experiences.  My doc reviewed the research and consulted with pharmacists ultimately finding that nothing has been documented associating decreased lymphocytes with a prezista/truvada/norvir regimen.  Now that doesn't mean that it can't happen but given the lack of evidence, it also doesn't seem very probable to us.

Why did you switch from Reyetaz?  Best of luck with your next labs.  Hopefully this is just a little slump for both of us!

--- Quote from: newt on May 09, 2013, 03:12:44 PM ---I am interested to see what new meds you doc suggests. A combination with no nukes (specifically no tenofovir) may help.

Good luck

- matt

--- End quote ---

We haven't really discussed the specifics yet.  My doc wants to wait another 3 months and take another look at my labs first.  A hematologist work up showed zinc levels on the low end of normal so I am testing out a daily zinc supplement first to see if that has any effect.

My doc did make reference to Stribild so that option doesn't get rid of the tenofovir.  I'd really like to stay on a 1x/day regimen so the options there are limited.  Why do you suspect removing tenofovir may help? 

Unfortunately I was only on Atripla for a few sets of labs.  My #'s were relatively stable during that time but then again, it is only a few data points so it might be a leap to draw any conclusions on the introduction of Prezista.

Thanks for the well wishes -- for now we are just playing the 3-month waiting game!


" Why did you switch from Reyetaz?  Best of luck with your next labs.  Hopefully this is just a little slump for both of us! "

  My liver was taking a dump !
   I spent three to four hours a day  on the toilet while taking Reyetaz !

    I also had a a year long orange glow  :o

    My husband always told people it was my Italian blood   ???

    I feel so much better !   Toilet paper is not first on the shopping list !

    I would like to say my liver feels better , but it does not  :(

     I'll let you know in three months how I am doing !



if you would draw you data:

03/12 <20     579  40
06/12 <20     405  47
09/12 <20     384  44

on a math. graph you would see that it fits a perfect parabolic decay

extrapolating the parabola goes to a plateau of ca. 198

the parabolic decay factor is 2. (which is quite good, mine is 1.56...)

Let me explain: it is not because your viral load is undetectable that is means that ALL your CD4s are virus free. the ultimate target of long term medication is that most (hopefully almost all, ultimately all) CD4s are virus free.

Therefore virus 'tainted' CD4s must go. (die). And if you have had no CD4 up-modulating illness (such as a flu or any MCH class 2 infection), then as the 'tainted' CD4s go down and the virus-free pool remains stable, and, then such a parabolic decay can be observed...

200 is your base of virus free CD4s and you immune system can from now on build up from that base.

200 virus free CD4 is certainly a better prospect than 200 virus infected CD4s

From now on it reasonably possible that the favorable built up takes place. That process may be slow since half life of virus free CD4 is 6 months and half life of CD8 is 9 months. Age over 50 will make it even slower

(your VL at around 10k shows that your dynamics are quite slow to start with)

If not, then of course, the meds are not fulfilling the job entirely ( meaning freeing the body from infected cells) and the most likely ones to have lost effectiveness are your NRTIs

I sympathize with the fact that this 200 number may create a bit of anxiety, but if they are good , 'healthy' CD4s and with such a good percentage (%) , they will do the job, and, I would recommend that you do not worry too much on it

(easy for me to say, as I am prone to anxiety myself)

wishing you well


I don't know if this would be much of a help but coming from someone as myself who have been positive since late 2005, I've always had a problem with my cd4 Viral load has always been undetectable...I started talking to a friend of mine who has the same condition and he highly recommended that I start taking multi vitamins..since then my cd4 count has went up at least close to 500 from a 300 in the past 3 months.. and the only other medicine I take is atripla...hope this helps good luck :)

Hopefully you can switch and aren't resistant to the other 1-a-day options like Complera or Stribild.

My count raised from 60-408 on Complera along with multivitamins, going to the gym, having a fast metabolism and fish oil capsules. I'm not perfect, I party a lot too!

I've stayed away from all protease inhibtors due to all the running-to-the-bathroom stories.

Good luck and hopefully this passes


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