Question
Do I need to start treatment?
25 June 2012. Related: All topics, Starting treatment.
My CD4 count is 375.
What do I do?
Do I start treatment?
Answer
With a CD4 count of 375, your immune system is still good. Both the BHIVA (British HIV Association) and WHO (World Health Organisation) treatment guidelines recommend starting with a CD4 count of 350.
There is no immediate rush for you to start treatment straightway. However, CD4 counts tend to continue dropping over time, when someone is not on treatment. How fast or how slow this happens, is different for each individual. Some people start treatment within a year or two of being infected. Others can take 8 years or more before they need to start.
Although your CD4 count is good, at 375 it is relatively close to 350. You may therefore find it useful to start thinking about preparing for when you will start treatment. Our guide to An introduction to combination therapy answers a lot of questions you may have around this.
Dear Zim
It is good that you have already started taking ARVs. The aim of ARVs is to bring down your viral load to undetectable levels by the time you deliver. Viral load is the amount of virus in your body. Undetectable viral load means there is very little virus. Taking ARVs and having an undetectable viral load dramatically reduces the risk of passing HIV onto your baby. It is therefore important that you continue taking your ARVs as prescribed by your doctor.
In response to your second question, the safest method for feeding your baby will depend on where you live. This is because different countries have different guidelines for the management of HIV in pregnancy.
As you did not specify where you live, I will give you a general answer. Here in the UK, the BHIVA (British HIV Association) guidelines on the management of HIV in pregnancy recommend bottle feeding. This is because, in the UK and most western countries where mothers can have access to to formula milk, clean water and bottle sterilising equipment, the risk of transmitting HIV to the baby through bottle feeding is zero.
However, there are some countries where mothers do not have easy access to the above facilities. In these countries, the WHO (World Health Organisation) guidelines recommend that if a woman is taking ARVs (antiretroviral treatment for HIV), then she should breastfeed exclusively for 6 months. Taking ARVs and having an undetectable viral load dramatically reduces the risk of transmission through breastfeeding. Exclusive breastfeeding is recommended because studies have shown that mixed feeding carries a greater risk of transmisiion. After 6 months the baby can then be weaned onto a safe diet without breastfeeding.
Good luck for the rest of you pregnancy.
Im 5 months pregnant ive got hiv and i started arvs on the 25 of june,is it possible that my baby can be hiv positive and i want to breastfeed my baby can you give an opion.