Q and A

Question

Shall I expect my CD4 count to rise?

Hi,

Just before I started treatment my CD4 was:

August ’08 CD4 330, 17% , VL 250,000

I went onto Atripla in September ’08 and in the first 6 months of meds it’s so far been:

October ’08 CD4 258, 20% VL 906

November ’08 CD4 242, 21% VL133

December ’08, VL-undetectable

February ’09 CD4 162, 28% VL undetectable

I recently had a bad skin rash and from going to my clinic about the rash I found out that I had caught chlamydia jan /feb.

Are the above results to be expected in light of my recent infection, since treated, and should I expect the CD4 count to rise?

Thanks for any guidance.

Answer

Many doctors would consider the percentage a more stable indicator of the level of damage of the immune system. In your case-it is 28% and that is a great result. The absolute number, however, is not ‘wonderful’.

An active chlamydia infection can have an effect on the absolute CD4 count.

Generally, there aren’t many options, but to wait and see how the things will develop. Some medical professionals suggest using selenium and alpha lipoic acid to try to boost the absolute number of the CD4 in a case like yours.

It may also make sense to check the total lymphocytes and the white blood cells to check whether they have fluctuated, as this could explain the reduction of the absolute CD4 count.

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