I read that, in HIV treatment, CD4 levels are the main way to monitor the condition of the immune system and risks of diseases/Kaposi's Sarcoma.

But, I see other comments about natural killer cells and that they help suppress cancers.

Is there a much higher risk of cancers, including Kaposi's Sarcoma, if there are a normal number of CD4 cells, but a low number of natural killer cells?

If so, do you recommend monitoring natural killer cells and is there a treatment to boost them if they are low or less functional?

Many thanks.

In HIV-infected individuals CD4 cells are the most important determinant of risk of cancer. When CD4 cells are low, the risk of cancer (Kaposi's sarcoma and lymphoma) is greatest. When CD4 counts are high, the risk of cancer is lowest.

HOWEVER, your query serves to make the point that CD4 cells are NOT the only part of the immune system which determines one's risk for cancer. The immune system is very complex and many elements of the system (including natural killer cells) help determine one's risk for developing cancer. This would explain why some patients have aggressive Kaposi's sarcoma despite having a very high CD4 level. I would NOT recommend having your natural killer cells measured since there are no data that really correlate natural killer levels with risk of cancer. Similarly there is no easy way to boost them. Although the study of natural killer cells is an area of intense research, it is not ready for prime-time in terms of entering into the clinical arena.