Question
Is my CD4 count reduced by SLE?
1 November 2023. Related: All topics, CD4 and viral load.
Hi, I have been taking my medication since I was a child till date. I’m 24 growing and my CD4 was high but for the past ten years I haven’t tested to check it….three years ago found out I have systemic lupus erythematosus. My viral load is undetectable but when I checked my CD4 last month it was very low 135, what could be the cause? I take my medication everyday now mum thinks am not taking my medication. I have some oral thrush that doesn’t go away and consistent fungal/UTI plus my skin itches a lot.
Answer
Hi, how are you doing?
Are you taking treatment for what else you have mentioned e.g., the oral thrush and UTI?
Have you been on any treatment specifically for SLE? A common problem with SLE is low white blood cells, most commonly affecting CD4 cells.
This can mean that HIV is not the reason for your low CD4 count. This would be suggested because you have remained on your treatment and your viral load is undetectable.
Now that you have found your CD4 count is low, have you been started on an antibiotic called co-trimoxazle? This is used to prevent further infections as your immune system is currently weaker than normal.
Being HIV positive and having SLE at the same time is a rare combination. Are you under any specialists? You would need a rheumatologist and an HIV doctor to make a management plan to make sure your HIV treatment is balanced with any immunosuppressants you may require for treating SLE.
Josh.
Hi Raka, your results are conclusive and you do not have HIV.
At i-base we are not doctors and cannot provide medical advice. Please speak to your doctor about possible causes of this fungal infection.
Hello josh sir, raka again
I have completed my 6 month of exposure
I have my test result cd4 – 1243, hiv ag/ab cmia method 0.14 sir i have one question why little fungle infection on my skin appearing these are little but i am confused please give me some suggestion please clear my doubt
Hi Anna, as your viral load is still undetectable. This proves to both you and your mum that you are still taking your medication every day.
Even being on treatment, your CD4 count can change as has happened likely with SLE. But viral load when on treatment will not change unless you stop taking it or do not adhere to it daily. Being suppressed means your treatment is still working and that your CD4 count will have dropped for a different reason.
I understand it may be difficult, but is it possible for your HIV doctor and your rheumatologist to speak with each other? Being HIV positive and have SLE is a rare combination and should be managed by your doctors together to ensure they treat you appropriately.
It is good that you have started co-trimoxazole to help with your immune system while it is lower. Even if you are unable to see your doctors together are you able to see your rheumatologist before retesting in 6 months? They may be able to offer another treatment that can help with your CD4 count rather than waiting to see what happens in 6 months.
No was just told to take cotrimoxazole and fluconazol and should be retested after 6months
Hi Anna, it is good to know that you are taking your treatments to hopefully feel better soon.
Has your rheumatologist mentioned anything about your low CD4 count?
Am taking fluconazol for the thrush and hydroxychloroquine for the SLE and yes I am taking cotrimoxazole ……I am seeing a rheumatologist and hiv doctor separately