Question

I started treatment at a high CD4- will I live longer?

21 March 2012. Related: All topics, South Africa.

This site is full of excellent information. Thank you!

My question: when diagnosed my CD4 was 450 and my VL (viral load) was 10,300. I began treatment after diagnosis and my current numbers 3 months later are CD4 670 and VL undetected.

With the numbers given with my diagnosis, can it be interpreted that I was diagnosed early before too much damage was done to my immune system?

I got tested when I was having bad headaches and had a rash in December of 2011. I began treatment immediately. Before that, I have not suffered any illnesses since I have been sexually active.

Many cases I hear people being diagnosed with VL in the millions and CD4 much lower than mine was. I’m just trying to understand if my scenario will help me be a long time survivor.

Thanks for your help!

Answer

Answer: Rebecca McDowall

Hello,

Thank-you for your question and for the positive feedback about the site.

It’s great to hear you have responded so well to treatment. A CD4 count of 670 and undetectable viral load is a great result!

You asked if your CD4 and Viral Load readings indicated that you were diagnosed early.It is not possible to tell from your first CD4/ viral load readings when you were infected. This is because HIV affects each individual differently. The ‘normal’ CD4 range (without HIV) is anything from 400-1600. A post-infection CD4 count of 450 would therefore mean something quite different for somebody who normally has a CD4 of 500 compared to a normal CD4 count of 1500.

What may be important, however, is your CD4 count when you start treatment. People with a higher CD4 count when treatment is started are more likely to reach ‘normal’ (over 500) levels. Most guidelines (including in the UK and South Africa) recommend starting treatment with a CD4 of 350 or under. In the USA treatment is recommended for CD4 counts below 500. Some recent studies have suggested that starting at a higher CD4 may have long-term health benefits. The most important study looking at this is the START trial. You can read about this trial at this link.

You said you are trying to understand if you will be a ‘long time survivor’. With modern HIV treatment and care people can expect to live for many years on antiretroviral treatment. Even with CD4 counts much lower and viral loads much higher than yours this is true. Recent studies have shown that HIV positive people on treatment can expect to live almost as long as somebody without HIV. If you keep taking your treatment properly and look after yourself this should be the case for you.

Do you have access to any support right now? You may find that speaking to other HIV positive people will help you to adjust your recent diagnosis. Your clinic should be able to put you in touch with a support group. Or if you prefer if you tell us where you live we will try to put you in touch with a local group.

You may find it interesting to look at our ‘Introduction to Combination Therapy’ guide. It will talk you a lot of the questions you may have about treatment and living with HIV. You can read the guide online at this link.