Question
Does it matter if you start treatment with a low CD4 count?
3 March 2006. Related: All topics, CD4 and viral load, Starting treatment.
Answer
Over one third of all new HIV diagnoses in the UK are in people whose CD4 count is already less than 200 cells/mm3. This is higher in African people and highest still in African men. Anyone whose CD4 count drops below 200 is at risk of serious opportunistic infections and the lower it drops, the higher the chance that the infection will require more toxic drugs, and may even be fatal.
Starting treatment before the CD4 count falls below 200 is the best time to use treatment. You are likely to get less side effects and the treatment is less likely to cause ‘immune reconstitution illnesses’. This is a term that describes serious illnesses become active in people whose immune system become dramatically stronger very quickly because of HIV treatment, and which starts an infection that waspresent but that was not previously diagnosed.
You can still respond well to treatment – even if you start when your CD4 count is less than 50 cells/mm3 – but you are asking the medications to do a much more difficult job.
(Adapted from a question from the i-Base Q&A pages of the African Eye a new treatment publication for African communities affected by HIV who are living in the UK)
Hi Dwight,
I’m really sorry to hear your story. It sounds very tough.
But how are you doing now? Are you still on ART and do you have access to your CD4 count and viral load results?
Please let us know.
I live in Houston Texas. I’ve been positive for 38 years. When I was first tested my CD4 was three. I had meningitis tuberculosis I went from 220 down to 90 pounds. I had PCP 10 to 15 times. I had a whole bunch of other diseases. I’ve been in hospice three times. When I was in hospice they took all the meds away pictures made me comfortable said I was going to die. But I came out of it and I’m still here. I’m not saying it was easy it was very hard. I lost 15 years of my memory because of all the medicines and drugs from the doctors that I was taken. I do not do good on medicine. Did Kami medicine for cholesterol. Three weeks later I ended up in the hospital. Bad reaction to the meds.