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As Told By Laury:

Dear Laury:
About two months ago my doctor and I decided that I should take an STI (Supervised Treatment Interruption). Prior to stopping my HIV meds, I had an undetectable viral load and my T-cells were at 726. My doctor told me during this treatment interruption there was a possibility that I could form a viral load rebound. About a month into my interruption I visited my doctor and had some tests done to see how my interruption was coming along, and it turns out that my T-cells had dropped to 456 and my viral load went up to 91,000. I am obviously back on my HIV medications, but I would like to know if there is something that you can suggest that will help me regain my T-cells and bring down my viral load to an undetectable status?
Sincerely,
Rebound Girl

Dear Rebound Girl:
Although it may seem like these labs are terrible, they're really not. In fact, what you just experienced is pretty normal for someone taking a planned break. Everybody is different, but usually the virus has a little party for the first couple months and then settles down a bit. I'm going to guess that your CD4s were around 375 when you started anti-viral meds (I called the psychic hotline). If that's correct, then your body is reacting normally to the break. Had you stayed on the break, your CD4s may have stabilized around 350-450, but there's no way to know for sure. Unfortunately, it's pretty rare that the CD4s will stay at the level you gained when you were on meds (726 in your case). So, to answer your question… to get your count back up and your viral load back to undetectable the most important thing you can do is to take all your meds when you're supposed to (or at least 95% of them). Other than that, the usual "healthy lifestyle" stuff comes in to play:

Limit Alcohol: Too much alcohol can decrease your blood cells, and CD4s are a type of white blood cell.

Eat right: I highly recommend the book "Superfoods Rx" by Steven Pratt

Exercise: Your CD4s like to stick to the sides of your veins, so exercising helps to get them "unstuck". A trick for getting a good CD4 result is to do 25 jumping jacks before you get your blood drawn!

Reduce stress:
Stress can wreak havoc on your immune system.

Stop Smoking:
I know, this is the last thing you want to hear (especially when I just told you to reduce stress), but other than all the bad stuff you already know about, one study showed that smoking may decrease the immune and virological responses to antivirals by as much as 40%. 1 The study was too small to prove anything, but it's one more reason to think about quitting. The Tobacco Quit Line (1- 877-270-STOP) can give you some great resources.

1Miguez-Burbano MJ; Burbano X; Ashkin D, Pitchenik A. Addiciton Biology, March, 2003, vol 8 no 1 pp 39-43.

Dear Laury:
About two months ago my doctor and I decided that I should take an STI (Supervised Treatment Interruption). Prior to stopping my HIV meds, I had an undetectable viral load and my T-cells were at 726. My doctor told me during this treatment interruption there was a possibility that I could form a viral load rebound. About a month into my interruption I visited my doctor and had some tests done to see how my interruption was coming along, and it turns out that my T-cells had dropped to 456 and my viral load went up to 91,000. I am obviously back on my HIV medications, but I would like to know if there is something that you can suggest that will help me regain my T-cells and bring down my viral load to an undetectable status?

Sincerely, Rebound Girl

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