Question
What can I do if my CD4 is 58 and my doctor hasn’t arranged ART yet?
8 February 2021. Related: All topics, CD4 and viral load.
I am a 49 year old female, I have never smoked and only drank occasionally.
I have a CD4 count of 58 and a viral load of 112,000 this seams very bad and I am very worried. I have also been diagnosed with Hepatitis C. Can I be treated and live as long as someone with a CD4 count of 200 or above. I am so scared that I won’t be able to watch my grandkids grow up.
My PCP doctor has referred me to an infectious disease doctor but they have not contacted me to setup an appointment and I know from reading other Q and A’s that it is imperative that I start ART ASAP. I also work in daycare environment and my husband doesn’t want me to go back to work until I’m on an antibiotic but we really need the money especially now. I’ve read that ART is expensive. I live in the US.
Answer
Thanks for getting in touch.
Even though your CD4 count is now low, HIV treatment (called ART) is very effective. So long as you can access ART and you take these meds carefully, you can definitely expect to see your grandkids grow up. At 49 you are still young and have a lot of life ahead of you :)
In the US, you should be able to access ART like any other medication. This will either be through your insurance provider or through public health programmes such as ADAP (AIDS Drug Assistance Programme). This operates in every State.
If you don’t have medical care, the following organisation should be able to help:
https://www.gmhc.org
As you have not started ART yet, I assume that this is a new diagnosis. You are right that your low CD4 counts means it is important that you start ART asap. Please contact both the ID specialist and your own doctor again to find out when this will happen. Do not take no for an answer. You have a health issue that needs prompt treatment.
Once you start ART your viral load will drop and your CD4 will rise. Even with a low CD4 count, your CD4 can rise to normal levels. This is something that will take time, but it is better that this happens steadily over the next few years.
Because your CD4 count is low, you also need to be prescribed an antibiotic called co-trimoxazole. This will protect you against other infections until your CD4 count becomes much higher on ART.
A low CD4 count doesn’t mean that you can’t work, but your husband is right that it would be better to get antibiotics and ART first.
Not being on ART with a low CD4 count increases your risk from Covid-19. This makes it important to be extra careful. In the UK your HIV results and ow CD4 counts would enable you an early COVID vaccine. Even though this varies in different US states, please also try to register for a vaccine.
Together, these are all reasons why it is important that you talk to your doctor again. And your doctor should help you fast-track access to the ID specialist for HIV treatment and the COVID vaccine.
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