5 months on Atripla

[TNDude]

When I started on Atripla in March my VL was 106,000 and CD4 was 404. After a month I went down to a VL of 230 and CD4 of 549. Just got June results and my VL is now undetectable but CD4 went down to 354. Of course doc says he is not concerned with the CD4 drop but very pleased with VL being undetectable. I will know August results in a week. He told me not to worry but naturally I have been worrying some. I know CD4's can vary. I guess I'm just looking for some re-assurance that this isn't worth worrying over just yet. He said he fully expects CD4's to go up. He said I should be thrilled with achieving the ultimate goal, which is an undetectable VL. Thanks in advance for any thoughts.

[mikey62]

wow, that's really good news.  your doctor is right, don't worry so much about your CD4 count, at least for now.  mine didn't change as much as my VL and percentage.  I've always read and heard that becoming undetectable and a higher percentage are more imortant than CD4 count.  but it's always nice to see higher CD4 counts also.  I think it just gives us a little more reassurance that we're doing well.
I just started Atripla July22 (after a month on Truvada/Sustiva) and my doctor says my VL should be undeectable the next time I go back.  I'll know my numbers on Aug 24.

Don't worry about your CD4, they will go back up, but they also change from time to time.  Like I said, the more important numbers are percentage & VL.   Congrats!!

[J220]

Yes, CD4's can vary a lot, maybe even on a daily basis. They will bounce up and down hereon, so don't give it any thought. Also, you should be aware that our CD4's may not return to the regular range of 1000 or whatever normal is, as the damage has already been done. But the average you have seems like mine, and according to my doctor at that mid range the immune system is "still strong" in his words, and that's good enough for me. So don't be concerned with your varying CD4's, they will continue to go up and down, which is normal.

[Ann]

Also, you should be aware that our CD4's will never hit the regular range of 1000 or whatever normal is, as the damage has already been done.

Not necessarily true. "Never" is a pretty strong word to use in an instance like this. A mate of mine had to go on meds within the first couple years of her infection when her CD4s crashed into the 100s. Her numbers these days are typically between 1200 and 900, with a percent in the upper 30s or lower 40s. She's been on meds for about eight years, and her CD4s have been fantastic for at least five or six.

Everyone is different. There's some evidence that people who had naturally higher CD4 counts before hiv can have high CD4s after hiv and meds. Remember, CD4s in the 500s are for some, even without hiv, normal.

Ann

[J220]

Agreed...I changed it to "may" not, which should be more accurate. Thanks.

[Brian360]

I've been on Atripla for a year and a half now and in that time my viral load has stayed non-detectable and for the first time since starting treatment my CD4 rose to 160 two months ago..  Considering when I started Atripla my CD4 was probably in the 30's, I'm lucky to probably even admit that I've nearly finished a two year degree since in the same amount of time i've been taking Atripla.

Like everyone else has said...worry more about your viral load than your CD4 count.  I've felt pretty good since my VL has been non-detectable.

[Inchlingblue]

As a general rule, CD4 increases with Sustiva are less than with other meds. This of course is statistical and individual results can vary.

"It's interesting that despite the fact that Sustiva always seems to do the best virologically, it doesn't do the best from a CD4 standpoint. Almost everything that you compare it with has a better CD4 response. This has been shown for protease inhibitors, for Isentress, for Selzentry."

LINK:

http://www.thebody.com/content/confs/ias2009/art53122.html#boosting

[hades01]

Thanks!
I need it to read all this today that i am going to my follow up. I been um detectable since and of December and the CD has been up and down.
Hopefully this time will be over 300
199 08-2008
189 12-2008
308 03-2009
274 06-2009
09-30-2009 ?
Best to all!
Eduardo