Question
My CD4 count is declining, should I worry?
16 January 2014. Related: All topics, CD4 and viral load.
I have been on second line therapy with ATV/R+ TDF+FTC for 3 years after 1st line drugs for 11 years.
My CD4 counts have fluctuated from 977 – 823 – 743 – 642 – 546 within one year. But my viral load is undetectable.
Is this immunological failure? If I have second line failure are there any options available?
Answer
Hi,
Thanks for your email.
In the UK, if you had an unexpected change in your CD4 count, this would be checked against your CD4 percentage. It’s normal for CD4 counts to fluctuate- go up and down- and CD4 count tests can have a large margin of error. CD4 counts tend to vary a lot- especially at high levels like this.
The CD4 percentage is a more stable measurement of how many CD4 cells you have in comparison to your other immune cells. If this is relatively stable then the decrease in your CD4 count is unlikely to be significant.
When you’re on treatment the most important thing is that your viral load stays undetectable. This means that the virus isn’t able to replicate and therefore can’t damage your immune system further.
Because your CD4 count is still very good, and your viral load is undetectable, you shouldn’t worry, and changing treatment isn’t necessary but it is worth talking to your doctor about your concerns.
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