I've been taking Atripla for 13 months now - every day no misses. My labs in May 07 were 232 / 32200. I started Atripla in June 2007. My base (diagnosed 8/05) was 375 /56600. I was undetectable by 8/07 with CD4 of 419. I'm still undetectable but these are my questions:

My CD4's have been going up - 741 in May 2008 (500+ in 11 months) - in July I was down to 680. Is this drop the start of a trend or do CD4 #'s go up and down?

Is being undetectable (<50 vl) the goal?

Now that I've been <50 (undetectable) for over a year, what are the chances I will develop resistance to Atripla even if I maintain adherence?

Are my earlier, pre-treatment, numbers and subsequent response to treatment indicators of continued success?

In this vein - and related to the earlier question about variations in CD4 levels while undetectable - what would be the CD4 range for someone who is not HIV+...do uninfected people's CD4 # go up and down? Is someone with the "maximum" CD4 level more healthy than someone at the lower end of the uninfected range?

What things can I do to help Atripla to raise my CD4 count?

Thank you in advance for taking the time to answer this long message!

Mike

CD4 counts go up and down. They are lower in the morning and higher in the evening, and can be affected by stress, other medical conditions, immunizations, among other reasons. A more stable number over time is to follow is the CD4%. Your CD4 counts are great now. No need to do anything else. Yes, getting to and staying < 50 is the goal. It is possible, though unlikely that given your excellent adherence that this regimen will fail. Your pretreatment numbers do help inform us to some degree as to the kind of response we might see. But there are other factors (viral strain, underlying genetics of your immune system, among others) that also predict success or failure.