Q and A

Question

Does treatment work if you start with a low CD4 count?

Hello

Can a person with a very low CD4 cells count below 200 recover his health by taking treatment and live more than a decade?

Thank you.

Answer

Hi

Thanks for your question.

Treatment will work at any CD4 count.

However the lower it goes below 200, then greater the risk that something serious might happen before this. If your count is already low and you have been lucky so far, then starting now is important. If your count is still above 200 now, then starting before it drops below 200 is important.

Most current guidelines recommend starting when the CD4 count is around 350, if you have access to newer medication that doesn’t require using d4T (stavudine) or AZT (zidovudine).

The main limitation from starting with a low CD4 count is that this will limit how high your CD4 count can recover.

A recent study provided some guidelines as to what this mean in practice. We also reported this research in HTB.

CD4 increases strongly correlated with CD4 count when they started treatment.

For example, the following percentages of people reached a CD4 count over 500:

41 comments

  1. myank

    hi.. my cd4 count is 121..after igot seek ihadfever
    for seven days …which art medicine should i take gide me i m frm india..

  2. sudipta

    Adam are your figures real?did you have so much increase in cd4?Thats really very encouraging. How old are you?

  3. Rebecca McDowall

    Hi Ola,
    Stopping treatment is not generally recommended. Your viral load can increase again very within weeks and your CD4 count is likely to drop and it will be more difficult to recover when you restart treatment.

    If you are finding it difficult to take your drugs every day it’s important to try to get some support. Your clinic or health adviser should be able to give you some support with this. You can also read about adherence and get some tips from our guide to combination therapy.

  4. ola

    After attaining a good CD4 count,can a patient stop the use of the drugs.please,I will like to know.Taking drugs on a dairly basis is not easy at all.

  5. Rob

    Hi everyone! I got an HIV diagnosis four weeks ago after being ill for a long time and I suppose living in denial. My CD4 count was 4, my viral load nearly a million. I’m probably still in denial and finding it very hard to accept, compounded by the worry of being able to recover from such a low count. I am also very depressed and anxious and this concerns me because stress can affect CD4 counts. Please give some more stories of your hopeful experiences.

  6. Andy

    I started HAART last July with a CD4 count of 98 and viral loal of over 400,000 – my last bloods in February show a viral load which is undectable and my CD4 count is now 243. Thanks to Adam and Anjuna for posting. Hearing others improvements gives me a real sense of optimism!

  7. Charlotte Walker

    Hello, thank you for your question. Eating a nutritious diet is very important if you are HIV positive. Please follow this link to a website which has more information on this. There are other tests for TB available including skin tests and x-rays but not all countries are able to offer these tests as they can be quite expensive. Maybe you should talk to your doctor about these options. Please let us know if you have any further questions. Thanks.

  8. Connie

    I have a problem with my CD4 counts, it is only 20. I don’t know what to eat or drink to boost it. I took TB treatment before I started HIV treatment but I still cough. The doctor says he can’t find TB in my body anymore but I am worried about the symptoms I am experiencing. Is there any other way of checking for TB except the sputum test?
    Please help.

  9. Adam

    I started ART 9 years ago with a CD4 count of 4 and a viral load of over 1 million. Two and a half month ago my CD4 exceeded 800 and my viral load was undetectable. Faith, good will, optimism and a sense of humor are and always will be OUR BEST FRIENDS!!! Best regards Adam.

  10. Anjuna

    Hi,

    Just to let you know that my brother was diagnosed back in February 2008 with a CD4 count of 4!

    We all had no idea of it prior to him being admitted to hospital with a opportunistic infection but mercifully since then – after he started his treatment – his CD4 count has recovered and at the last count it was above 300.

    All the best

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