Unfortunately, I've never had C4a measured correctly, so I can't contribute as much as I would like.
However, my understanding is that C4a is related specifically to mold reactivity. Having a high C4a means that people are "over tolerance" -- being exposed to more mold than their bodies can handle.
When i started taking Famvir, my mold reactivity went up for three days. Then it went down below baseline.
When I started taking Valcyte, my mold reactivity went up for several months. I compensated by moving to a particularly pristine environment. After about six months, it went down below baseline and then continued to decline.
Now, after 12 months on the drug and an additional five months off of it, my mold reactivity is close to resolved. I'm affected by blatantly moldy buildings (e.g. ones where, when I look up, there are big water marks on the ceiling and that would have knocked me out three years ago), but not appreciably at all to smaller exposures. (There's a particular type of outdoor toxin that continues to be problematic though.)
I thus would posit that the IRIS flare of Valcyte, ARV's and (it seems) GcMAF makes people more reactive for a while, increasing their C4a's when exposure remains unchanged.
In theory, extended time on the drugs has the potential of decreasing reactivity below baseline. But if the IRIS is too severe (signified by C4a levels being out of control high), that may never happen. And detox (which I've worked on intensively, more than anyone I've ever encountered) seems extremely important too.
Of course, this is just conjecture, based on my own experiences and other people's reports.
Best, Lisa