Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Slow slide?

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Hey guys,
  Went to the doc yesterday and got all my blood work reports.  I was particularly interested in my PSA and bilirubin, both of which came in plenty low.  Triglycerides were well within normal and my total cholesterol is 145.  My viral load is 0 and my % is 22.  That's the good news.  Now for the hard to interpret news.  My tcells are 320.  From 10/2005 to now I've had 4 bloodworks spaced regularly: the results 433/355/360/320 - am I discerning a negative trend - why is everything else ok but my tcells continue to languish and erode? (doctor didn't like that word).  I'm on Reyataz, Norvir and Truvada.  My compliance is excellent.  I have a very healthy lifestyle.  What gives?  Why can't I get it up?   ;D  Any thoughts and suggestions?  If this trend continues. I'll be in critically low tcell zones in a little over a year, if not sooner. 


Well, CD4 counts vary by +/- 50, so a trend, perhaps, but perhaps not. If the % is stable I wouldn't worry.

...however, for further investigation when worrying about if it is a trend or not...

1. Descending CD4 count on effective (ie viral load undetectable) combo can indicate mitochonrial toxicity ie metabolic damage at cellular level, probably from the nukes.  This is dose related, so maybe some adjustment will be possible. The general view is that the two drugs in Truvada are least harmful mitochodria wise, but, as ever, personal factors like genetics etc, are important.

2. Non-HIV (drug) related cause (need to see a haematologist).

- matt

First of all, I've only broken the 400 mark on CD4 cells once in the past 18 years. Most of that time I've been between the 100s and 200s. My nadir was 35 in 1995. Right now I'm around 130. I wouldn't obsess a whole lot on CD4s unless you see a steady upward trend in your viral load.  My docs seem to focus a lot more on the viral load than on CD4 counts. There are so many treatment options now, assuming you're fairly new to the game, that you should relax, particularly if you respect your doctor.

Thanks guys for the posts.  I'm not worried or afraid - just a proactive thinker - if the downward trend is a reality, I'll need a plan B.  Thanks newt for the great link.  I'm bookmarking the site.  If anyone else has a similar experience please let me know.



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