Question
Will my CD4 count ever get back to ‘normal’ levels?
11 July 2012. Related: All topics, CD4 and viral load, Opportunistic infections.
Will my CD4 ever get back to OK levels?
I was diagnosed late with PCP, CD4 17 and VL 1.7 million. Now after 15 months my VL has just become undetectable (was very nearly so last time) and my CD4 has crawled up to 208.
Previous CD4 counts were 170, 200, 142, 184.
I am still on the same regimen I started out with darunavir/r, Truvada which suits me well.
It would be nice to stop the prophylactics and not worry about my fragile immune system. Will this ever happen?
Answer
It’s really good that you are doing so well on your current treatment, and that it suits you. How are you doing generally health-wise?
It’s great too that you have achieved an undetectable viral load and increase in your CD4 count. And not long after starting treatment. You mention that you worry about your fragile immune system.There is no reason for you to do so. This is because, in terms of how your CD4 count has increased, you are doing really well compared to other people who start treatment with such a low CD4 count. And although it may seem like the increase is slow, it is steady and rising.
In response to your main question, your CD4 count when you start treatment has is one of the guides to how high it will reach after treatment.
Because you started with a count under 50, this makes getting above 200 and higher more difficult. However, there is a wide range of individual responses. Some people starting this low reach 300 or 400 or higher, but it is more difficult, and you will only know this with time. Also, getting your CD4 count to increase slowly and steadily is much better than if it jumped up quickly.
You were very sick and were lucky to be diagnosed in time for treatment to work amazingly well. A CD4 count of 200 is great. Very few HIV-related infections occur when your CD4 count is this high. You have had a great response to treatment and you are out of the risk zone. Although a ‘normal’ CD4 count is referred to as 500, you can still lead a very full, health active life with a lower count.
You asked about whether you could stop taking prophylaxis. Prophylaxis such as cotrimoxazole (Septrin) protects you from developing opportunistic infections. These are infections such as PCP ( pneumonia) which you had, which can develop when your CD4 count is below 200. For any drug or treatment, you need to look at the risks and benefits.
Talk to your doctor about how long s/he think you will needs this. If it is helping, then an additional pill may be worth continuing. This is not generally recommended for people who have had PCP. If you didn’t have PCP, you may be able to stop this based on your CD4 count reaching 200.
Best wishes.
Hi Chelle,
Your friends CD4 count is very low. They are going to need to take ARVs and preferable as soon as possible. They should ideally also be getting specialist care and following the advice that is in this link: http://i-base.info/qa/4643
Your friends family should be as supportive as possible. They also need to know that HIV is no longer the illness it used to be. Its easy to treat and people can live normal lives, and long lives. Being on medication is fundamental for this.
I have a friend whose CD4 is an 11 and he has not started treatment. He is headed to the emergency room today. What can his family expect next? They just learned he has HIV a week ago.
Hi Roy,
It’s great to hear that you’re doing really well on HIV treatment (ART). And I agree that it’s important all decisions about ART are joint decisions between you and the doctor.
My CD4 was 41 when I was diagnosed in 2005. It is now 1230. So, yes it is definitely possible for your CD4 count to become normal and even much higher than normal, if you stick to your medicine and do exactly what the doctor tells you to do. As a matter of fact, I recently had a small basal cell cancer cut off my neck and it was supposed to take about two weeks to heal. It only took about one. And my fingernails, toe nails and hair grow much faster than they ever have in my life.