Question
Why is my CD4 T cell count not increasing?
25 August 2016. Related: All topics, CD4 and viral load, South Africa, Starting treatment.
Why is my CD4 count not increasing? I started treatment when my CD4 was 380 and viral load 8800. 6 months later and my CD4 is 357 and viral load 38. Is there by any chance that I could get sick because of my CD4. I’m on tribuss treatment.
Answer
Hi,
Thanks for your question.
Firstly, it looks like you are doing very well on treatment. Your viral load is now below 50 which means it’s undetectable. This is great for your health and drastically reduces any risk of you passing on HIV through sex.
CD4 changes occur more slowly. Just as it usually takes many years for the CD4 count to fall when not on treatment, they take many months and years to see the full benefit of treatment.
CD4 counts are only a rough marker of your immune system. The results fluctuate throughout the day with lower readings in the morning and higher later in the day. They can also be affected by exercise, other viruses and various different factors. Yours hasn’t fluctuated by a large amount and you haven’t been on treatment long so you don’t need to worry.
As with viral load, the response will be related to the CD4 level when you start treatment. The lower it is, the more slowly it is likely to take to respond, and also the less likely that you will reach the high levels.
Whether the trend or average levels are going up or down is more important – and that’s why your doctor will want to check you CD4 regularly to make sure it is generally increasing.
By being on treatment with an undetectable viral load you are doing the best you can to stop getting sick and it’s only if your CD4 count decreases dramatically and/or continually that you are at risk.
Your doctor will hopefully able to help you plot out your viral load and CD4 count overtime so you can follow your progress.
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