Question
Is my CD4 count too low to reach normal when I start treatment?
26 March 2010. Related: All topics, CD4 and viral load, Starting treatment.
I’m a 42 year old man diagnosed HIV positive on 2nd of Feb 2010. My probable infection date was in July 2006. I have swelling of a lymph node on my forearm and some nerve tingling sensation on my right leg otherwise I don’t have any obvious signs or illnesses.
My CD4 count is 224 with a viral load of 10,000. I haven’t started treatment yet as the doctor is waiting for my full resistance profile but I should be starting when I go back to the doctor in 2 weeks time.
With my CD4 count already relatively low can I expect it to come back to a normal level? Even if the treatment works, am I likely to develop HIV-related illnesses in the future and continue to experience various illnesses connected with HIV?
Although the doctor has said that I can expect to live almost a normal lifespan is it possible to give a realistic life expectancy? I am scared.
Answer
Thank you for your question.
Please don’t be scared. I understand there is a lot to take in but you are doing the right thing by getting the information you need about HIV and CD4 counts.
There are many people who have had much lower CD4 counts than yours who have gone on to do very well on treatment. Some people live very healthily with CD4 counts of 300-400 and never reach above 500. Although the guidance is for people to start treatment when a CD4 count gets to 350 or below, starting treatment, when, with what, is a very individual thing. A normal CD4 count is also different for each person. Don’t get to hung up on the numbers, the evidence is that once you start treatment you are bound to do well.
For more information on this, please see a similar question by following this link
If you take your medication correctly and consistently you should not experience HIV-related illnesses in the future.
Your doctor is correct about you having an almost normal life expectancy once on treatment. Recent studies have shown people with HIV can live for over 35 years once on treatment. That would make you 77 which is a good age to reach and there is nothing stopping you living longer even than that.
For more information on these studies please follow this link
If you require any further information please contact us either via the web or by phoning the treatment information line (Mon-Wed 12-4pm)
Hi,
From what you’ve said, it does sound like his CD4 count is very low. It sounds like he has several opportunistic infections. He should be getting specialist treatment. It can happen that a patient needs to be treated for an opportunistic infection before they start ARVs. This will be up to your brothers doctor.
With ARVs his CD4 count will improve.
Hi hello everyone. Please allow me to join the group. I am not sick but my younger brother. It was 2014 when he told me that he had a contact with hiv positive guy. That guy was his boyfriend and don’t want to used any protection. It was only one day he shared to my brother that he is positive and my brother cried a lot why he never told him or atleast protect him. After couple of days they broke up. He did not see that guy anymore. My brother is Sexually active with different partner so we don’t know how many of them now are positive. Anyway, 2015 he started having skin problems which he believes an allergy. If he has too much stress or lack of sleep, it will start with lot of red spot and itchy. I was already speculating that he might got the virus but so denial and scared to get check up. He is also very sickly like sudden fever for no reason. He went to dermatologist and the doctor said it is psoriasis. No medicine even cure his skin as I was reading nothing can cure psoriasis. I insisted that he must get blood test for hiv. Until this early March 2019 he don’t feel well. He’s cathing his breath even he did not do anything. He’s also coughing, sweating in the evening despite his room is aircon. Then finally he got his check up and he is positive. He don’t get his medicine yet for hiv which I don’t have any idea. The doctor said that he got pneumonia and has to take medication for 21 days. He also got another medicine for his tongue as there are white spots and he loss his appetite. Yesterday he just went to the doctor for his cd4 count and it was too low. He is not responding me yet how low as I’m am now in Europe and he is in Asia. His boyfriend asked me if what will happen if your cd4 is too low.. I don’t know how much should a normal CD4 count is, how we can say if it is too low and so bad. Hope someone can share about their thoughts, dos and don’t for my brother. Thank you.
Hi Matt,
No it doesn’t. As long as you’re on meds your CD4 count will rise. It may also help to know that its common to be diagnosed with a CD4 count in single figures. With medication you’ll be fine.
So that doesn’t necessarily I’ve progressed to AIDS within a year of infection?
Hi Matt,
Your nurse is right. This is what can happen, especially if the infection is resent. Please see here: http://i-base.info/qa/12828
I recently tested positive in early February. My baseline CD4 count was 179 which is concerning to me. I had a negative test in November 2017 so i wouldn’t think within a year i could have progressed to the advanced stages. The nurse seemed to think this wasn’t all that unusual early in the disease before treatment.
Hi Elliot,
Your HIV is under control because your viral load is undetectable. Your CD4 count does seem a little low especially seeing as you’ve been positive since 2003. What’s your CD4 history?
The immune vitamins are unlikely to be of any benefit and shouldn’t really be taken unless a doctor has suggested them.
I’ve been pos since 2003. My doctor recent changed my treatment to biktarvy QD, within one month my vl went from 3000 to undetectable, but my cd4 count went from 164 to 124 in 2 month time, and my last labs showed cd4 92. Granted I did have a flu like cold when i had labs drawn the latest time. I do no drugs, and have no other health issues. What could be going on with my cd4 count? I just bought some Kpax Immune vitamins recommended by a pharmacist friend of mine. Let me know your thoughts, please.
Thank you
Hi Brian,
You have started on the right track. Because it’s recommended that everyone who is HIV positive starts treatment. And this can be at any CD4 count.
Sleep disturbance is a reported side effect of efavirenz. But it’s a good idea to ask your doctor to look at your skin if you have itchiness and a rash.
Did you have a viral load (VL) test after your diagnosis? You can ask your doctor for this result, and also ask why you have to wait for 6 months on treatment for another VL test. Here’s a Q&A about how quickly your viral load reduces on starting HIV treatment (ART). Having a viral load test can confirm you are on the right track.
I was diagonised with Hiv on 19th July 2018 and started my treatment on 20th just the following day, i have received my CD4 Count now it is 352 and my doctor says that my viral load will be taken after i reach 6 months on treatment that means January next year. i feel atleast stronger and av gain some weight since then am on efavirenz 600 mg/lamivudine 300 mg/tenofovir disoproxil fumarate 300 and i feel itchiness and lack of sleep is this normal ? and am i on the right track.