Question
Does treatment work if you start with a low CD4 count?
5 January 2010. Related: All topics, CD4 and viral load, Living with HIV long-term, Starting treatment.
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:
I was just recently diagnosed with having HIV, my CD4 is 210 but my CD4 percent it 12%. After one month I still haven’t had treatment due to waiting for all my results to come back. I have oral thrush, which the Dr. gave me Nystatin but it didn’t fully work. I also have a cough. I’m confused on what to do next.
Hi Debashis,
If you’re asking if it’s possible to recover when a person is diagnosed with a low CD4 count, then answer is yes. Your wife is going to need to start treatment, so ARVs. The ARVs, will in time increase her CD4 count. She should also be using antibiotics, the name of these will vary depending on where it is that you live, one name is bactrim.
My wife hiv reactive n cd4 count now108 she just started the ART treatment for 3 days and herp infection on her tongue she lost 4 to 5 lbs can she recover mam she is only one kn this world for me plz reply me mam m in deep mental agony.
Hi Indra,
It’s great to hear that your CD4 is now 361, this is a good sign. Given that your CD4 is now 361 it is very unlikely that you’ll have any opportunistic infections as these happen when someone has a low CD4 count.
Hi! My recent CD4 is 361. Am i now safe from opportunistic infection?
Hi Felix,
Have you been on ART for long? If you have just started treatment it can take a while for your CD4 count to recover to higher levels. Here’s a page from ART in Pictures that shows how CD4 counts recover once you’re on ART.
However, please see your doctor about the rash on your face. This could be a side effect of your meds. So it’s a good idea to have the doctor look at it to find out what’s causing it.
Modern ART is safe and effective and it’s easier to take than earlier treatment. A CD4 count is used less to describe AIDS today. Being on ART and having an undetectable viral load is the way to keep healthy. But please talk to the doctor about whether you need to take antibiotics while your CD4 recovers and gets stronger.
My CD4 is 184 meanwhile am on ART and rashes started pouring on my face what should i do. My cd4 is 184 does that mean am having aids
Hi Al,
Many people are diagnosed with CD4’s in the 200’s and they do just fine. You will though need to start meds. The meds will control your HIV. In time your CD4 will increase. For more info about starting meds please see here:
http://i-base.info/guides/starting
For life expectancy info, see Q10 here:
http://i-base.info/qa/what-are-the-most-asked-questions
And CD4 results here:
http://i-base.info/qa/20
Just got my CD4 test result. Test result shows 227 the other one is 13%. I don’t quite understand the figure so well. Also, i’d like to know what my chances are given the cd4 test result that I have. Thanks.
Hi Mpho,
When are you due to see a HIV specialist?