Why is this happening?

[Dragonette]

Hi girls & guys

I am concerned: my CD4 dropped to 180.  I could feel that I was slipping, got yiest infection and sores in my mouth.
I am on meds for a year. I was diagnosed with CD4=77 & VL 20,000, and I started treatment right away. Switched Combivir to Viread 3 months later, which I take with Epivir + Stokrin (Sustiva). On the Combivir I went to undetectable and CD4=300, but since then I dropped to CD4=230, up to 270, and now back under the 200. I never miss doses, and I even quit smoking (until I got my results that is). I feel very uncomfortable the wrong side of 200 (hope this doesn't insult anybody). When I was diagnosed HIV was so new to me and I had no idea of the dangers entailed, but now I do and am scared. I am yet undetectable and I pray to remain that way. The doc suggested switching Stokrin to Viramune but I don't want to change so much in so short a time.

Thank you for your opinions, all the best

[newt]

Don;t sweat it, CD4s bounce around like bunnies, expect +/- 50 difference.  Only worry if the fall becomes a trend, like 3 results downwards in a row. There is unlikely to be any benefit in switching Stocrin for Viramune.

HIV+ smokers tend to have higher CD4 counts (er, yes, all that junk activating the immune system...). This is not a reason for HIV+ people to resume smoking once they quit, it will be, on balance, more harmful.

- matt

[Dragonette]

I am once again so grateful for this forum. I can't think of anywhere else where I would get an informed answer within minutes.
Thank you Matt

[risred1]

getting cd4 up can be a long slow process.

So you might want to look at selenium supps in a good multi vitamin, and try charging you immune system up with a herbal supplement like Eurethro and Astragalus.

Since I am not a doctor or councilor, I suggest you look at various information from buyers clubs, such as newyorkbuyersclub.org. They are dedicated to people with HIV and publish information about various supps. If you are deficient in certain nutrients, there may be a reason you CD4 is not up where you would like it. (their multi is called added protection without Iron.) Iron is an interesting thing to watch. Meds can actually increase iron load in your body, so supps plus Iron have to be watched. Best to talk to a specialist doctor about it. additionally, if iron deficiency is the problem, anemia and other related issues can occur, which can sap your energy.)

Additionally, when you test may have an impact. If you tested after a Vaccine shot, there may be an "adjustment". Often they correct themselves, but you may have to ignore test done shortly after flu shots.

I also suggest you look at Dr. Jon Kaiser site for additional information. he has done boutique care for years, and while many docs are suspicious of boutique care, I think he has an interesting point of view about how to manage HIV. He has a supp formula that he as sells and has published information regarding cd4 boost based upon his formula. There are also reports regarding selenium as a supplement having a measurable affect.

He addresses overall health and possible impacts to ones immune system and how to bolster. He focuses on Gut Health and talks quite a bit about intestinal parasites. I did have parasites and it did affect my CD4 and VL. Since treatment, I rebounded to where I was. (not to say that is your reason.)

Additionally, I have seen that smokers do not rebound faster than non smokers, my understanding is that smoking has a suppressive effect on CD4 recovery, and therefore is not a good thing to do to "help" your CD4. Additionally, my specialist kept at me about how bad drinking is, which was annoying because I don't drink. The message is, booze doesn't help either and needs to be very moderate.  The recommendation I'm hearing is 3 glass of wine a week. Not much if you like to have a few.

So if your focusing on restoring as much of your CD4 as you can, look for nutritional help, get tested for Hormone Levels, Tested for Intestinal parasites, no smoking and no drinking, and get some exercise and regular and sufficient sleep, which normally is considered 8 hours!

all my best.

[pozguy1978]

CD4 counts are greatly affected by diet.  Since your VL is undectectable diet and excercize may be the key to bolsteering your CD4s.  Ester-C  at about 1000mg per day is a good thing to suppliment, also try NAC (n-acycital cystene). 


Best of luck

[Andy Velez]

Dragon, you've gotten some great advice here. I will only add that if you go with supplements or any of the other suggestions be sure to discuss them with your doctor so that he/she knows what you're doing.

Good luck and keep us posted on how it's going.

[budndallastx]

Only other question that comes to mind is what is your CD4 percentage?  As everyone indicated, the CD4 jumps but the percentage gives a better understanding of what's going on. 

Also, this site has some cool graphing tool for your lab results so you can record and see the trends.  Look up under "Cool Tools" above.