Q and A

Question

Will interleukin-2 increase my CD4 count now I am on treatment?

HELP!!! My CD4 count has only stabilised at 129 after 3 yrs on HAART. I was diagnosed HIV positive in October 2007 with a CD4 count of 3 – yes 3 and a viral load of 54,000. I immediately started treatment with Kivexa and Sustiva (efavirenz), and I am still on this first line treatment today.

My VL dropped to less than 50 copies after 5 months on HAART and remains at less than 50 copies to date. I am really anxious and worried sick as my CD4 count isn’t going above 200 and my HIV doctor says it never will get to 200. My HIV doctor is more concerned at keeping my viral load less than 50 copies and that other patients have lower CD4 counts than myself and not to worry.

I have read on i-Base about Interleukin-2 (IL-2) for patients with low CD4 counts after 1-2 years on treatment. Could this help me?

Answer

Thank you for your question.

Please do not worry about your low CD4 count. You are right that it is better to have a CD4 count above 200 but you are doing everything you can, and it may just take more time. Starting with such a low count can take longer to reach 200. It may still increase, but if it doesn’t you still have good protection from treatment.

Your doctor is correct in saying that the viral load is the most important thing to monitor when you are on treatment. As long as it is below 50 (undetectable) then that is the most important thing.

Initial findings supported the use of interleukin-2 (IL-2) to increase CD4 counts in people on treatment with counts below 200. See this study review from 2001 for more information.

However more recent larger studies in 2009 found that the CD4 cells that were generated as a result of IL-2 use were actually not beneficial. This is because the new CD4 cells were not functioning properly and so did not appear to reduce the risk of illnesses. It was also because IL-2 was associated with side effects, sometimes serious ones, and these cancelled out any potential benefits. For more details about this study please follow this link.

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