Question

Should I restart ART if my CD4 count is high and VL is undetectable?

19 August 2024. Related: All topics, CD4 and viral load, Starting treatment, Stopping treatment.

I stopped my ARVs one year ago when my cd4 was 1375 and viral load was undetectable.

Now my cd4 is still high at 1230 and and my viral load is still undetectable after a year without treatment.

Should I start ARVs again or wait?

Answer

Answer: Simon Collins

Hi there

Thanks – this is a great question.

Your situation is also so unusual that there are different options.

First would be good to check that you are definitely HIV positive? How high was your viral load was before you first started treatment?

Did you have a laboratory test to confirm you are HIV positive?

We sometimes hear of people who start treatment based on only one positive HIV test.

Second, it is easy to restarting treatment. At some time your viral load is likely to rebound without ARVs so this would stop you worrying about when this might happen.

The third option is you could stay off ARVs This would involve close and more frequent viral load monitoring.

Guidelines recognise that there is limited data in people with your current results. This means there is an option to either restart or stay off and monitor