Is there a "normal" CD4 recovery rate?

Nov 16, 2008

Hi -

Are there any studies or published data on how fast patients' CD4 levels rise? If so, can you say what is the "average" recovery curve? Is that information sorted by age, general health, other risk factors?

My husband started treatment 6 mo. ago following PCP. His VL is now undetectable and his last CD4 was 120. I am told these are all good outcomes. Nonetheless, we would feel a lot more at ease if we had numbers to compare to and knew what to expect. Not to mention, we have a competitive spirit, and want to beat the curve!

Thank you so much for your time.

Response from Dr. Holodniy

There are numerous published curves, primarily from clinical trials that track CD4 increases over time. In general, in patients who have never been on HIV meds, the average increase in CD4 count is about 150 CD4 cells over the first 6 months, with some modest further improvement going forward. This increase is related to the baseline CD4 count, HIV drug combination, presence of underlying drug resistance, adherence to the regimen, age of the patient, among many other factors. The lower your CD4 count is when you start, the longer it may take for your CD4 count to increase. The important fact is getting the viral load undetectable and essentially shutting down HIV viral replication so the immune system can recover. You don't indicate what the starting CD4 count was. It is however a very good sign that the viral load is now undetectable.