Q and A

Question

My CD4 count is falling and I am still undetectable…

Hello, I have been positive since 1991, on ART treatment since 1996 and am super compliant. My viral load has been undetectable since then. I am 54 years old, and my CD4 has slowly drifted from 600 to 350 over the last five years. In 1996 my lowest CD4 was 350 before I started ART. I am worried that my CD4 count is dropping while the virus remains undetectable. Any other things one can do to boost the immune system with recent medical research? Are there any treatment candidates enabling the immune system to recover that can be combined with ART? Is there medical research in the field of restoring the immune system being worked on?

Answer

Hi, how are you doing?

Have you had any investigations for your CD4 count falling? It is possible that this is a normal ageing response. As more CD4 cells become exposed to infection over the years, the count found in the blood reduces. As you are undetectable, HIV is not impacting on your immune system and is not the cause for this decline.

Do you have any other ongoing health conditions that could have impacted your CD4 count? And over the last few years in this decline, has your count ever gone back up for any of your readings?

And do you happen to know your CD4%? This can be a more accurate result of how your immune system is functioning? Given how CD4 counts can be affected by more than just HIV, it is not always a reliable measure of your immune systems health.

Unfortunately, in the context of HIV, using ARVs are the only known way to improve your count. This is more so to allow the body to naturally recover its own CD4 count rather than the ARVs boosting production of more. For this reason there is currently nothing else you can do to help boost your own immunity  aside from following a balanced diet to ensure you are have all the nutrients/vitamins required for your body to use.

Josh.

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