Question
How fast will my CD4 count go up?
23 December 2023. Related: All topics, CD4 and viral load, Newly diagnosed.
Hi, my CD4 was 55 back on May, but my viral load was not disclosed by my doctor as the results were not in yet. My CD4 went up to 114 and my viral load was 51 copies. I know I’m on the road to undetected viral load, my question is how fast would my CD4 foes up after this?
Answer
Hi, how are you doing?
How long have you been on treatment?
A viral load of 51 is excellent. This is considered the same as undetectable as there is no longer a risk to partners. You cannot pass on HIV via sex when your viral load is this low.
It means your treatment is working and HIV is no longer having an impact on your health. It will allow your body to naturally recover its CD4 cells.
Recovery of CD4 cells is slow. It is great that it has already gone up from 55 to 114. Are you on a medication called co-trimoxazole?
As it is the body that recovers CD4 cells the process is slow. Unlike viral load which can be suppressed in a few months, CD4 recovery can take a few years.
It is encouraging that you have responded so well to treatment and your CD4 count has already doubled. It would be expected that it would return to a healthy range (430-1690) within a year or two. Unfortunately there is no way to speed up this process but you are going in the right direction.
Josh.
Hi Dan, it is great to hear that you are undetectable. An increase in your CD4 count from 55 to 127 is excellent. You do not need to worry.
Unlike viral load which becomes suppressed quickly and responds to medication fast, CD4 count recovery is much slower. The body needs to naturally recover its own CD4 cells and this takes time. Even small increases over time are encouraging and it is a very good sign that your CD4 count has been able to recover as much as it has.
Hi Josh, I went for my review today. My viral load is undetectable now, but my CD4 only increase to 127, should I be worry?
Hi Dan, this needs to be a discussion with your prescribing Dr. As i-base is an HIV treatment charity we cannot provide medical advise as we are not doctors.
Isoniazid is the most common treatment used for Tb treatment. A common side effect is numbness and this can be avoided when taken with pyradoxine. Other side effects can be found here: https://bnf.nice.org.uk/drugs/isoniazid/#side-effects
Please note even common side effects are only expected in around 10% of patients taking the medication. Common does not mean everyone will experience these side effects.
My doctor told me that I would be on the treatment for only 6 months, I worried back then that taking the medication would weaken me with the side effects on the early weeks, as what my bacteria and HAART treatment did for 2 weeks. Is there any side effects that I need to worry? My family has Alzheimer history and my father is having that now.
Hi Dan, why are you unable to start Tb prevention now?
Where do you live? In places with a high prevalence of Tb it is recommended that all people have 36 months of Tb preventative treatment. Usually this is with the medication Isonizaid.
The medicaments you have listed that you are currently on do not interact with Isoniazid. Has your doctor told you what their treatment plan is for you?
Hi, I’m Dan.
thanks for your reply, my medication is tenof-em an efavirenz. I’m also on bactrim, as the doctor would say. My goal now is to reach CD4 that enables me to stop taking bactrim and beginning my TB prevention treatment. My TB blood test was negative, but I don’t understand why my doctor advise me to take the prevention treatment.