Question
What if CD4 never goes above 200 on ART?
28 March 2024. Related: All topics, CD4 and viral load.
If CD4 count didn’t recover more than 200 after medication for many years and undetectable viral load then is there any impact on life expectancy ?
Taking Bactrim from 3 years due to low CD4 count so is Bactrim impact on to increase the CD4 count ? Google is saying yes.
If CD4 count is less than 200 from many years after medication then drinking alcohol 3 days in a week 13% ALC 375 ml is there any impact on health?
Answer
Hi there
Thanks for your email and allowing us to post an answer online.
Although most people see their CD4 count increase on ART some people get different responses. In perhaps 5-10% of people (called CD4 non responders), the CD4 counts stays stable or even continue to drop a little.
As long as your viral load is still undetectable, the main point is that your ART is still working really well. Having a CD4 count under 200 is much better if you are on ART than if you are not on ART.
The antibiotics in Bactrim – also called co-trimoxazole – will also protect you from infections that you are at higher risk from when the CD4 count is less than 200.
Neither HIV meds or antibiotics directly affect your CD4 count, but they will help keep you healthy and well. There is also a difference between being just under 200 and having a count that is less then 100 or 50. Without knowing your count it is difficult to comment further.
Alcohol doesn’t interact with any of your meds. The standard advice is that if an occasional drink is important for your quality of life, then in moderation this should be okay.
Other recent studies have reported that there is no safe level of alcohol, even within recommended levels. This becomes a question on quality of life though for each of us to be able to decide :)
A small study in the US is looking at whether the HIV drug fostemsavir can increase CD4 counts:
https://classic.clinicaltrials.gov/ct2/show/NCT05220358
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