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. mdu

    I started the treatment when my cd4 count was 138 n i also started using module8 immune booster is this right or wrong

  2. Simon Collins

    Hi Thozie

    I hope you are doing okay – it is better to have found out now while your CD4 count is still quite high.

    You will be akay if this takes a few weeks to start HIV treatment. IF it turns out you need TB treatment first, guidelines say this is best.

    IF you have symptoms, your doctor should explain this.

  3. Thozie

    Hello

    I have just found out that i am HIV positive last week Monday and my CD4 count is below 200 is 149 at the clinic they didn’t give me the treatment they said i must wait for the TB result i want to start the treatment immediately because i am becaming sick

  4. Simon Collins

    Hi Cruz, your doctor is giving you important and good information. The only way your immune system will get stronger is to start treatment. Treatment is very good and can make your immune system much stronger, but you need to take it to get the benefits. There is a small chance that other infections might happen but these are also usually manageable. If you start treatment now then within 6-12 months your CD4 count has a very good chance of increasing to at least above 100. The next year it might get above 200 etc. This will reduce the risk of PCP and other very serious infections.

  5. Cruz

    I was sick got admitted, did all tests I found out I’m hiv positive and the sickness was found as pcp pneumonia ,my cd4 count is 17, viral 250000. I am scared to start arvs since DR said my system is very weak, my doctor said I must my medication as soon NOW. what if the arvs makes me worst? I am ready to start taking them but what can I expert or what will happen?
    I am scared.

  6. Simon Collins

    Hi Timoteus – please talk to yor doctor. It is a good time to start treatment. The risk of delaying is tht you could become seriously ill very quickly. Also, your immune system might not recver as well.

  7. timoteus

    my cd4 count is below 200 but I didnt start medications.

  8. Robin Jakob

    Hi,

    Yes usually a person would continue. If they stopped taking ARVs their CD4 count would fall and they would be at risk of getting ill.

  9. charity makasi

    Whats happen if cd4 count raised from 225 to 1200 did a person stil continoue with ARVS

  10. Rebecca McDowall

    Hi Myank,
    ART (antiretroviral therapy) is usually made up of at least 3 HIV drugs. Which drugs are best is different for each person so it is important that you see a doctor or healthcare worker about this. Because your CD4 count is under 200 it is important that you start treatment very soon- in the next week or two.
    Have you seen a doctor to discuss starting treatment?

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