Question

Is this info on my brother and his CD4 count correct?

29 July 2011. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.

My brother has just been diagnosed HIV-positive. He has a CD4 count of 58 because of a secondary infection which is now being treated with high dose penicillin and prednisolone. His doctor (he lives in Spain) has said that this is because of the infection but that he will respond to treatment and his CD4 count will increase to what it should be. He says that he has got AIDS but he is panicking, is this correct?

Answer

Answer: Simon Collins

The prednisolone may be suppressing your brothers immune system a little but I haven’t seen studies that suggest this is a significant concern for HIV-positive people. This might be related to the dose though.

It is good that your brother has been diagnosed because even if his CD4 count is really a little higher, it is still likely to be well under 200. The is the minimum level recommended to start HIV treatment. More recent guidelines in many countries now recommend starting HIV treatment before your CD4 count falls below 350 or even 500.

Although these guidelines talk about ideal circumstances many people are similar to your brother in being diagnosed much later than this. Luckily treatment response is pretty similar at whatever CD4 count you start at.

The term AIDS is not really used very much now. Technically, anyone with a CD4 count that has ever dropped below 200 counts as an AIDS diagnosis in the USA but not in Europe. This difference is less relevant now that HIV treatment reverses the CD4 count for most people, often back to near-normal levels.

Ask whether your brother has good information about treatment. This is not a reason to panic but it is good to find out about treatment and how this have dramatically improved the outlook for anyone diagnosed today.

A good starter is the i-Base Introduction to Combination Therapy.