Question
Why has my CD4 count increased without treatment?
13 July 2012. Related: All topics, CD4 and viral load, HIV testing.
I tested HIV positive in November 2011 with a CD4 count of 947. In June 2012 I went back for CD4 count since I was told to have it checked after every 6months and it was 1247. I have not started medication. I was tested about 4 times using rapid HIV test and the result was positive. I am now confused because I thought my CD4 count should be going down instead of upwards.
What could be my problem, did the HIV test I undertook probably produce a false positive result? Please help.
Answer
A CD4 count of 1247 is great! It indicates that your immune system is very good. It also means that there is no immediate need for you to start treatment. Both UK and WHO (World Health Organisation) treatment guidelines recommend starting with a CD4 count of 350.
You mention that you tested positive using 4 rapid HIV tests. ‘Rapid’ refers to the time taken for the results and not the time since exposure that a test can be used. A positive result from a rapid test always needs to confirmed by a different laboratory test. It is therefore unlikely that 4 positive results would be incorrect.
I can appreciate your confusion regarding your high CD4 count. However, a high CD4 count does not necessarily mean that you do not have HIV. CD4 counts do fluctuate (can go up and down) depending on a number of factors. This includes the time of day the test was done. It could also be that you were recently infected and your CD4 count is increasing after the initial infection.
Do you know what your viral load is? Viral load refers to the amount of virus in your body. Usually this would be detectable, even with a high CD4 count. Though a small percentage of people (less than 0.01%) maintain a high CD4 count and undetectable viral load, without needing treatment. Please follow this link to our guide which explains how CD4 and viral load are related.
Best wishes.
Hi Glenrose,
Other than not being able to sleep, how are you now feeling?
Do you know what you were given? And is there any reason why the nurse didn’t explain to you why she was giving you an STD medication? Because I don’t know what she gave you, I can’t say.
Hi
I went to my local clinic after complaining about a back ache and abdomen pains after taking arvs for 6 weeks.
I explained to the nurse that l had hysterectomy a year ago after finding out that l had a touch of cancer. Okay she checked me, even put the finger inside me to check. l did have an infection but she gave an injection for std and anaerobyl 400 grms and pain killers paracetamol.
I did not sleep wel,l am worried why was l was given an STD injection when l was not infected with std?
Hi Lebo
This is an important question. It relates not just to best care but issues about access to treatment.
South African guidelines say that treatment should be available at any CD4 count. This is agreed by the government in the new National Strategic Plan on HIV, TB and STIs.
However, although 3.4 million people are currently on ART in SA, almost 7 million people are HIV positive.
How to get everyone on treatment – including those with the highest CD4 counts (ie above 500) is still being planned. The hope is this will happen soon.
By comparison, although the UK treatment guidelines recommend ART at all CD4 counts, the NHS still only commission ART for treatment when the CD4 count is around 350. In the UK people can get around this by saying they want ART to protect their partners from the risk of HIV transmission.
My question is in South Africa a person with hiv start taking treatment at what CD4 count? why they have to wait for people CD4 count to drops so that they can take medication. Why not start when the immune system is still strong?