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 Bunmi,
Starting HIV drugs (ART) is the best way to help your CD4 count recover. Here’s a picture from the guide ART in Pictures. It shows that ART causes viral load to drop quickly and then how the CD4 count recovers over time. Reaching a CD4 count above 500 is referred to as normal, but even if it doesn’t reach this high, the risk of HIV-related complications is dramatically reduced on ART. So, there’s lots of hope.
My CD4 count is 170 and I’m just starting drugs.. What’s my hope
Hi Shaky, do you know why your mum stopped the meds? If there was not a medical reason to stop, and side effects were not causing problems, them you mum needs to stay on treatment. A CD4 count of only 50 is very low and your mum is at risk of serious other infections. If she was getting side effects then are should be other meds available.
My mum’s cd4 is 48 she was on treatment thn stoped now started again how are the risks of her increasing the cd
Hi Tshepo,
Its great to hear that your CD4 is increasing. This is really important.
With regards to your weight, this is something that may increase over time.
Hi am Tshepo I was diagnosed with HIV and u recently found in July. My normal weight is 50 kg when I go to the gym is 55 I become fit .
Now am going to the gym putting so much weight but I cannt pick up. Why?
2. When I started the medication in August commiting it was 230 .
In October 20th my cd4 was 328 …. Am taking centrum multivitamin and immunace and ARVs everyday and eating a balance diet meal
3.will u gain weight when times goes on?
Hi
Your CD4 count may be doing very well – 135 is definitely better than 48. Sometimes when starting with a CD4 count under 50 it takes several years to slowly increase. Not everyone is able to get to very high CD4 levels again, but your current CD4 count will be protecting you against many HIV-related problems.
Are you in a country where you have your viral load tested? If yes, then this is the test that will say whether your drugs are still working.
If you don’t have access to a viral load test then the CD4 results will be interpreted for whether the drugs are still working.
If your CD4 count has steadily increased over the last three years, then the meds are likely to still be working very well. If your CD4 count increased to much higher levels though (for example to 200-300) and have now started to drop, then you may need to change treatment.
It sounds more likely that they are still working well though and it is just taking time to recover your CD4 count.
I started treatment in 2010 with a CD4 count of 48 and now its 135. Is that ok or i should change the drugs?
Dear Chris.
It’s good to know that you are feeling so much better.
The occasional worry with aches and pains could be due to any number of reasons. And may not necessarily be HIV related. There is no reason why you should get used to the aches and pains.
As with any symptoms, the best way to confirm what is causing them, will be to let your doctor know. He/she will be able to confirm for sure and treat you accordingly.
With best wishes.
Compared to death’s door, 15 months ago, very well! But quite seriously I haven’t felt as well as I do at the moment in ages, but there is still the occasional worry about aches and pains, or headaches, is it HIV-related etc? No doubt I’ll get used to it.