Question
My CD4 count seems to be dropping. What can I do?
5 November 2010. Related: All topics, CD4 and viral load, Starting treatment.
I tested positive in February 2010. My viral load was 10,000 and CD4 count was 231, two weeks later my viral load was 12,000 and CD4 count was 224. The readings were the same at the end of March.
I started on Atripla in April. Reading from the end of April was inconclusive as the blood sample wasn’t handled correctly. In July viral load was undetectable and CD4 count of 265. Results in November, from my most recent blood sample was that viral load was undetectable but CD4 count was 229, down below my very first reading.
Is there a reason my CD4 count would decrease? My doctor wasn’t overly concerned saying that it takes longer for the CD4 count to rise when starting from a low number but I am concerned. A slow rise in CD4 count would be one thing but a regression seems more serious to me.
I don’t drink alcohol, smoke or take drugs, have a good balanced diet and take regular exercise. I feel well and haven’t been sick since starting the treatment. Might my CD4 count stay permanently low or could it continue to decrease, even if my viral load stays undetectable? Is there anything I should try to do to try to boost my CD4 count? What might be the implications of a permanently low CD4 count even if my viral load remains undetectable? Apologies for the long-winded question and many thanks for your help.
Answer
Thank you for your question.
Please do not worry. It is normal for CD4 counts to fluctuate. Although your CD4 count appears to be decreasing the differences are very small between the figures and could be seen as remaining quite stable. The slight fluctuation could be as a result of many things including the time of day you tested, how much exercise you did before the test, how tired/stressed you are etc.
For more information about fluctuating CD4 counts please follow this link
Your doctor is correct that your CD4 count will take longer to increase once you have started treatment. Some people can take over a year on treatment before their CD4 count starts to increase.
Unfortunately there is little you can do to increase your CD4 count aside from taking ARVs. When you are on treatment the most important thing to monitor is your viral load which, now that you are on treatment, should remain undetectable.
Hello Amooti and thanks for getting in touch.
I am very sorry to hear you are not feeling better.
When someone is diagnosed so late as you were, it takes a long time for the immune system to recover.
Your CD4 count remains quite low and your doctor might have prescribed some extra medication for you to take.
This is to prevent opportunistic infections.
The more consistent you are with your ARVs and the better control you have of diabetes, your immune system will be able to recover.
Your bone pain can be caused by a lot of reasons.
It’s good to discuss with your doctor also but can be something very simple like vitamin D deficiency.
I am sorry you are feeling weak. The best thing you can do to recover is to remain on treatment.
Additionally, eating healthy and doing exercise can help both your immune system and your diabetes.
You can read more here:
https://i-base.info/guides/side/exercise-and-staying-active
https://i-base.info/guides/side/diet-a-balanced-diet-and-your-health
I understand from your message that you are a very strong and resilient person.
Continue taking your ARVs daily and get your diabetes under control and I promise you you will soon feel much better.
Things might look difficult right now, but don’t lose hope: persist and better days are coming
I was diagnosed Aids in 2003. CD4 was 1. By then VL measuring services were unavailable
Along the way I got Diabetes and TB
Now my VL is undetectable. CD4 is bellow 200.
Am weak. I have bone pain
Advise