Question

Question for a friend who may have been positive for many years

6 August 2024. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment, Support.

Hello I have a question for a friend.

He recently tested HIV+ and the second test was also positive. His CD4 count showed very low results of 10. He was told he may have had HIV for 10 to 14 years. Is that possible?

How could he have not known he had HIV all these years? As his health was fine and there was nothing unusual.

He experienced recently some mouth sores/cuts and a rash (thought to be eczema) and only after various tests and visits to various doctors and dermatologists did they think about HIV.

Thankfully he has not had any major health issues so far and he has been put on the antiviral treatment (ART).

My question: Is it too late for him now, having started treatment late and with a low CD4 count? Is there any hope for his life span? He is now in his mid 50s.

He has had his eyes checked and there is no damage but recently he has had puffy eyes. Is there anything to be concerned about? Are there any other measures we can take?

He says his mouth sores are getting better and so his his rash.
Is this a result of starting the treatment?

He is due to see the doctor for his next appointment to assess the CD4 count. But i am anxious for him, hence wanted some answers. How long does it take for the meds to work and for his CD4 count to increase generally?

Answer

Answer: Simon Collins

Hi there

Thanks for your questions for your friend which I will try to cover in order.

First, from these few details the doctor sounds right to suggest this is a late diagnosis. It sounds likely that he could have been HIV positive for ten years or more and only just found out now.

He has been lucky to not have had major health problems but the mouth and skin problems are common first symptoms.

Although his CD4 count is very low, this will start to steadily increase in response to treatment. ART starts to work from the very first pill. The improvements in symptoms are a sign that his CD4 count is already becoming stronger.

If he is careful at taking his meds, the CD4 count will steadily get stronger again, perhaps increasing to over 100 in the first year and then keep increasing over the next years. His life expectancy should also be very good.

Other than ART, there is nothing else he specifically needs to take although health lifestyle choices are a good idea.