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Author Topic: Dramatic drop of CD4  (Read 2477 times)

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Offline Polo4TLB

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Dramatic drop of CD4
« on: February 13, 2013, 06:33:24 PM »
Hello I am Tony.

I have been positive since 2005, and on meds (Truvada and Viramune) since 2007.  I immediately went to undetectable after starting meds, and have pretty much stayed there with the exception of a couple tiny blips (never more than 70 VL since 2007)

My cd4 had gradually risen over time from 200, and the high was actually labs I took before the most recent.  CD4 in Nov 2012 was 735.7 and % was 31.8.
The labs I took on 2/7/13 was CD4 510.6 and % was 28.3.

Now I know there are fluctuations as I have been this level a few times over the years but It went up and the drop was never as dramatic, BUT I think the following thing's MAY be contributing:

1.  Lost 70 lbs over the last 5 or 6 months
2.  WAS exercising REALLY hard 2 times a day
3.  Started Vitamin D ( was EXTREMELY LOW, and when I started mega dose, I started loosing weight)
4.  Sore through and sickly feeling when labs drawn
5.  Was diagnosed the same day with Epidimitis and was given CIPRO (so apparently had infection)
6.  I am Bipolar (on Lamictal and wellbutrin xl)
7.  WAS on Androgel, but stopped about a month ago because I had lost weight and was excersing , thinking I would, could make my own..  ALSO I was loosing my hair (now growing back)

SO...  do you all think I should worry OR wait it out.. 
Do you all think that the items I listed could have played a role in the HUGE BLIP?

Thank you all very much for any advice!!

Offline mecch

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Re: Dramatic drop of CD4
« Reply #1 on: February 13, 2013, 06:38:37 PM »
I dunno.  Possibly you are stressing a bit much. Is your CD4 change "huge"?  Did your doc express concern with these numbers? 

By the way, "blip" usually refers to a small spike in viral load from undetectable.

Welcome to the forum, on any account!
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline Polo4TLB

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Re: Dramatic drop of CD4
« Reply #2 on: February 13, 2013, 07:01:16 PM »
Thanks for the Welcome!!

225 points, I call that Huge, but I do tend to obsess a bit too much about my health.

My doctor is new to me, He is just a PCP that I choose to go to because here in Oklahoma HIV docs do NOT do Comprehensive care and REQUIRE you to have a PCP (in California and Tennessee most docs preferred the Comprehensive method, as I did)  and since I have been stable for years I figured why go to and HIV doc that I did not like, when my PCP can order the same labs she does.  As that is all she did since I have always been on the same meds, and been Undetectable since starting.

My point is, although he has some experience in HIV, he doesn't have a whole bunch..  ANYWAY he JUST called and told me not to worry about it, that it could be the loss of weight or heavy exercise..  As long as VL is UD he is not worried.

Offline WillyWump

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Re: Dramatic drop of CD4
« Reply #3 on: February 13, 2013, 07:09:28 PM »
I wouldnt stress over this. Yes, you've had a drop but it's not huge. Even at 510 you still have very good numbers. Yes I know it's not the 700ish you are used to but I bet these numbers will bounce back up. You mentioned an infection and sore throat etc..these may have played a part in the drop.

I just lost almost half my CD4's, I went form 912 to 489. I was sickly for a couple of months and my doc thinks this is behind my drop. But we expect mine to rise back up.

Dont stress and lose more of those babies  :P


POZ since '08

Last Labs-
11-6-14 CD4- 871, UD
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir

Offline Ann

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Re: Dramatic drop of CD4
« Reply #4 on: February 14, 2013, 05:32:05 AM »
Hi Tony, welcome to the forums.

What's most important when you're on meds is that your VL remains UD. Don't stress about your CD4s - even with the drop, they're still in the "normal" range.

CD4s can vary as much as 100 or so points during the course of a single day. So no, your drop wasn't clinically significant. CD4s tend to be lower in the morning and higher later on in the day, so if you had your blood drawn earlier in the day than usual, that may have contributed to some of the drop. CD4s can bounce around for no apparent reason as well; mine always have.

There's an article at poz.com you may be interested in reading: CD4 Only Needed Once A Year When UD, Another Study Says. The article ends with this summary:

The study authors argued that reducing CD4 screens to once per year for virally suppressed patients would save both money and the anxiety patients often suffer from observing the fluctuations in CD4 counts that aren’t clinically relevant.

Don't sweat the drop - celebrate the fact that the meds are keeping your virus controlled and undetectable. :)
Condoms are a girl's best friend

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Offline anniebc

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Re: Dramatic drop of CD4
« Reply #5 on: February 14, 2013, 04:42:35 PM »
Hi Polo

Welcome to the forums.

I can't add anymore to what Ann has already told, what I'm concerned about is your weight loss, 70lbs in 5/6 months is way to much, you need to talk to a dietitian, or your Doc, also exercise is good but but don't over do things, you can put too much stress on your body, especially after all that weight loss.

As for your Vit D deficiency, mega doses are not needed, take a regular dose everyday and it will built up at a more normal level over a decent period of time.

Never knock on deaths door..ring the bell and run..he really hates that.

Offline Polo4TLB

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Re: Dramatic drop of CD4
« Reply #6 on: February 14, 2013, 09:00:14 PM »
Hi and thanks again for the Welcomes!

Well I have been averaging 1/2 a pound a day weight loss.  I have actually spoke to a dietitan and my doctors, and everybody seems OK with it.  I eat less than 1,600 calories a day and haven't exercised in a week because I have epididymitis , and it hurts, and the other day, I slipped in my shower like an idiot and fell over the side of the tub and the toilet, taking the rod and curtin down with me..lol so needless to say I'm sore over that too!  But did exercises allot and when I start back up i will do it less often and less strenuous!

In the back of my mind I have often thought the weight loss was because I was wasting or something or have cancer, but no one seems to be worried.  I was 100lbs overweight so I guess its easier to loose weight when your fat...  BUT honestly withing a week of taking the VIT d 50,000 iu a week,( I was like 12 which was way below the bottom range, considered WAY deficient so normal doses would have NEVER brought me back up)  I started loosing weight and I didnt even try, well after 10lbs or so, I got motivated and started eating better, and stopped drinking ANY sugar, etc.. after another 20 lbs, I joined the gym, and everyday learn more and more about what to eat, etc, and its becoming a Way of life, BUT I still worry theres something wrong.  (that's just me though)  about the VIT D, I am now t the top end (like 76) and on 1000 iu a day to maintain it.

Everything else in my blood work was in Range except for Platelets were 20 pts lower than bottom of range, BUT when I spoke to the DR yesterday he said not to worry! 

LOL now with my epididymitis, abdominal and groin pain I got to looking and fond that Truvada can cause Kidney damage and I am stressing about that.

The funny thing is I know that stressing about this stuff just makes the immune system worse off..  So i will try to go with the flow!

Thanks again for all the comments!
« Last Edit: February 14, 2013, 09:03:24 PM by Polo4TLB »

Offline tednlou2

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Re: Dramatic drop of CD4
« Reply #7 on: February 14, 2013, 10:31:53 PM »
Welcome to the forums.  CD4 drops do cause anxiety for many.  You've gotten good advice that it isn't significant. 

About the weight loss-- You said you exercise hard, and that you consume 1,600 calories a day.  I would think that has something to do with the weight loss, although you would want to have it checked.  I've been trying to lose weight, by calorie counting.  I allowed myself about 1,700 calories a day.  I have NOT been exercising.  I did lose about 20 pounds, but I am stuck at that.  When I lost that 20 pounds, I was doing a lot of landscape work over the summer.  Actually, I have probably gained back 5 of that. 

I am not exercising enough, and those 1,700 calories are too much for me to lose more weight, without either exercising or lowering my calories.  For someone exercising "hard," I would think you'd need more calories, or you're going to see a lot of weight loss.

Just something that stuck out to me.  You know your body.  If you feel your calorie intake is enough for the exercise you do, then I would discuss it with your doc. 


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