Q and A

Question

My CD4 count is 1 and I’ve just started meds…

I have a CD4 count of 1. What is my prognosis? I have just in the last few weeks started meds.

Answer

Hi

Great that you are now on treatment – how is everything going?

Even with such a low CD4 count, the meds should still work well. You are right to be positive.

Your CD4 count is likely to increase gradually. It might take a year to get to around 100 and another year to get to 200. This timescale is all good, but you might have a quicker or slower response.

Having a CD4 count of one, doesn’t mean you only have one CD4 cell. This is only a measure in a microlitre of blood. You could still have many tens of thousands of these immune cells in other parts of your body.

Good luck with everything – please let us know how you get on.

For more information see our guide to combination therapy.

See also: onformation on individual drugs.

8 comments

  1. Lisa Thorley

    Hi Glenn,

    Given that he lives in a remote area, then I would say yes, yes he can restart the Atripla. He does however sound quit ill. When is he due to see a doctor again?

  2. Glenn

    Thanks Lisa, it’s impossible for him to have a check up since they moved to their province. He lies in bed most of the time, he can only sit but having hard time to walk. If they go for a check up they need to carry him by foot before they reach the road for almost an hour. And another two hour travel on the treatment hub. He lives in my city before but his parents decided to move him to their province, our treatment hub in my city gave him that drug and yes it was Atripla. Is it safe to just restart that Atripla without going to his new treatment hub without consultation from a doctor? It’s been 11 days he stop taking his old ARVs.

  3. Lisa Thorley

    Hi Glenn,

    If he’s been given a pill that’s supposed to be taken at night its very likely that its Atripla, or a generic version of Atripla. Please see here:

    http://i-base.info/guides/1561

    With regards to when he starts the new ARV, this is something that he will need to talk to his doctor about.

  4. Glenn

    Thanks for the quick response Lisa. He stops his ARVs morethan a week now. I do remember our health care gave him lamivudine+tenofovir in 1 tablet and a separate efavirenz but after a health check on him they gave him a new drug and they mentioned it was only to be taken 1 tablet once a day at night. I dont know the combination but they told him that he needs to finish the first drugs they gave before he take that 1 pill a day. May i ask what is the combination of that pill? How about if he stops taking that lamivudine+tenofovir+efavirenz and start on that 1 tablet a day instead? Thanks again for answering our questions. God bless..

  5. Lisa Thorley

    Hi Glen,

    Its very important that your partner restarts his medication. This is even if he’s had some side effects. This is because his CD4 is very low. If he doesn’t restart his meds, his CD4 will drop. His health with be effected. Which given that it already has been, this is something that he needs to avoid.

    How long did he stop them for? If it was only a few days, then yes he can just restart his meds. He should though tell his doctor about this. And also tell his doctor about the side effects. Its very likely that the problems are due to the efavirenz. Please see Q3 here:

    http://i-base.info/qa/what-are-the-most-asked-questions

    Because you both have low CD4’s the following links may also help:

    http://i-base.info/qa/3560

    http://i-base.info/qa/4643

    This regards to you, because you’ve had a rash, you should tell your doctor about this. This is because a rash can be a sign of possible serious side effects. This needs to be looked at.

    Our guide to starting meds discusses side effects in more detail.

    http://i-base.info/guides/starting

  6. Glenn

    My partner was diagnosed HIV+ so do i last March, he has a CD4 count of 7 and mine was 138 were both men and he was hospitalized 5x, the hospital manage to treat the OIs like pneumonia. He has hepa b also and started ART with these combination (Lamivudine,Tenofovir and Efavirenz) we lived here in the Philippines. Upon reading forums i guess the line of treatment we are using here are old? Although it’s free because of our health insurance but i guess the side effects are our enemy here. My partner is taking hes meds now for 1 month but he stops it due to the side effects like hallucinations and blurred visions sometimes head ache and nausea. Is it possible to restart his ART using the same combination? They are in the part of my country were most poor people live. Other than that no other complications as of now. Is there a chance for him to increase the life expectancy when he restart ART? Thanks. Anyway i started ART after having 2 weeks of TB meds. My drug combinations are Lamivudine, Zidovudine and Efavirenz. Have lots of side effects like rash, head ache, nausea/vomiting, diarrhea and fatigue. How long will i manage the side effects? Lost my appetite also, i vomit when i eat.

  7. Simon Collins

    Hi Alahna

    Each person needs to be managed individually.

    Without more detail about the complications it is difficult to comment.

    For example, are these relating to symptoms before you were diagnosed? If yes, then HIV treatment may help. This may also depend on whether the symptoms were diagnosed as part of another infection.

    Or did these symptoms start after treatment and are you referring to possible side effects? One of the HIV meds called efavirenz causes neurological-type side effects. These usually improve within a few weeks but for more information see this link:
    http://i-base.info/guides/side/cns-side-effects

  8. Alahna

    Simon,

    Thank you for the positive response. I just started ART (09/05) with a CD4 count of 1 and there have been a lot of questions that I had wished I would have asked my ID doctor but at the time, they thought best to just get me on the ART and go from there. As someone that has gone through this process, are some of the neurological AIDS complications eased or does it become part of living a life with HIV/AIDS?

    Thank you.

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