Face HIV with Dr. Watiti

Dear doctor,
I have been on ARVs for over three years now and I feel fine. However, I have noticed that my CD4 count done on three occasions for monitoring purposes every six months, fell from 560 cells/ml to 490 cells/ml and the last time I checked it was 390 cells/ ml. When I did a viral load test it was found to be less than 400 copies per ml of blood. I do not feel sick but I am worried and fear the drugs may have stopped working on me. Shouldn’t I be put on stronger second line drugs?
Sarah

Dear Sarah,
MONITORING antiretroviral therapy can be done by checking CD4 counts, doing the viral load or checking the physical wellbeing of the person, for example checking weight and absence of opportunistic infections.

From what you have stated, though your CD4 count has dropped from 560 cells/ml to 390 cells/ml over a period of one-and-a-half years, you are clinically fine.

Your viral load is very low, meaning HIV in your body has been maximally suppressed. The second thing is that when reporting on the CD4 counts, they normally give you what is known as the reference or normal range which can be 400- 1590 cells/ml.

So, the normal CD4 count can be as low as 400 cells/ml or as high as 1590 cells/ml. Since 390 cells/ml is not very far from 400 cells/ml, you should not be worried.

So, you should continue swallowing your drugs since they have contained HIV in your body and it is not very active. You do not need second line drugs.

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