Question
What would happen if somebody starts with 0 CD4 count and on entry inhibitor?
22 July 2009. Related: All topics, CD4 and viral load, Cure.
What would happen if you started ARVs with an entry inhibitor if you had 0 CD4 count for a couple of months and you have not had ARVs before? I know, there is a very big risk of OIs, but would the immune system recover over time?
If there are no CD4 cells then the virus has nowhere to go and may be latent virus would then wake up in search of cells to infect.
Also, how about using HDACs? Or maybe transfusion of healthy blood? Or a combination of those with valporoic acid?
Answer
Unless the person is resistant to other classes of medicines, there is no particular reason of why he/she should start on an entry inhibitor.
If you have a very low CD4 count, even if it comes back as zero, it does not mean that your body have no immune cells. Only 2% of CD4 cells are in the blood – most are in the lymph system – and although it is not good to have a count that low, many people have been able to recover to higher levels after treatment.
Entry inhibitors do not prevent infection of CD4 cells on their own. They need to be used in combination with other ARVs. That is why, their particular usefulness in the situation that you describe is not huge. In addition, the only approved ones-enfuvirtide is taken in the form of injection twice daily and needs to be kept in the fridge. The other one-maraviroc (some people would classify it as a CCR5 inhibitor) is a bit problematic as before starting it, one needs a special test that is very expensive. All of that may turn to be a significant difficulty for somebody who is just starting treatment.
HDACs (Histone Deacetylase Inhibitors) affect the gene expression and are divided into four major groups. Their possible use is very far away from reality, as there are no enough data on how they will affect the body generally. They most probably will be linked to severe side effects and they most probably may be more useful with other conditions and not HIV-infection.
Blood transfusion will only lead to more opportunity for the virus to replicate and thus increase the viral load. Hence this strategy is not very promising.
As for valproic acid, here is an interesting article that you may find useful.
Hi Thapelo, this can change how the treatment is absorbed. Before doing this you should speak with your pharmacist or the doctor that prescribed the medication.
Hi it’s Thapelo again ..if I may ..does crashing Arv or dissolving Arv tablets still have the same effect on a patient..
Hi Thapelo, it is great that he started treatment. Even being on a low CD4 count, starting treatment will help his CD4 count recover and the antibiotic will help to prevent any other infections as his immune system recovers. How is your brother doing? Please see here for information about starting ART: https://i-base.info/guides/starting
Hi my name is Thapelo.a family member his on cd4 count is on 27, his never taken Arv’s before and his viral load is 900000 he just started his rehabilitation a week ago…with trenvir and antibiotics given to him..can he survive …am afraid and concerned..thanks
Hi Luna, as your grandmas CD4 count is this low has she been given any antibiotics? In most cases people are given co-trimoxazole (sometimes called Septrin or Bactrim). It is used to prevent other infections while your grandma has a low CD4 count, meaning she has a vulnerable immune system. It is important that she stays taking her ARVs. The only way for CD4 count to recover is for HIV to be suppressed. The body can then naturally recover its own CD4 count. This can be a slow process and can take a few years but it will steadily increase overtime. There are no extra ‘immune boosters’ or supplements that will help increase the speed of this process.
Good day my grandma was diagnosed with HIV 14 years ago and had been on and off on medication for 14 years and started ARV’s but would stop and continue she only got really really sick 2 time to the point where she would end up in the hospital this is the 3rd time they say her CD4 count is on 7 she lost weight but not to the point where you can tell she is positive she’s starting to see things now that she’s back on treatment and she’s only 52, we didn’t know she was positive until this Sunday when the hospital, we thought she had high blood pressure but she took care off herself the whole 14 years she took her vitamins and immune booster can someone tell me whay we can buy to boost her immune system and how long does your CD4 goes up and will she make it please anyone!!!!
Hi Gdeon, why does your sister not want to take ARVs? Her CD4 count is very low and this can only recover when taking ARVs. She is also at risk for other infections and should be on an antibiotic called co-trimoxazole. How is your sisters health? How does she feel?
my sister hiv positive and has 27 cd4 count but she does not want to take arvs what should i do really am confused
Hi Tricia, how are you doing?
What newer medication have you tried? Fat side effects are much less common with newer combinations. This is mostly true for fat changes arounf the face and legs.
Do you experience any of these symptoms while you are not on medication?
I was diagnosed with hiv in 2016. Right now my cd4 is 38 and viral load is 601,000. I am not on treatment right now. But when I was I had some unwanted side effects that not everyone gets. With me even with the newer medication causes the fatty buffalo painful hump in the back of my neck and also joint pain and weight in the abdomen. Changes in my face and legs loss of muscle and fat in areas. Is there a medication that won’t cause that? And why am I experiencing it.