CD4 Maximum Recovery Expectancy
Apr 8, 2017
Dear Dr. Young,
When would you consider that a patient on HAART has achieved his maximal potential for immune recovery? 2, 3, 5 years down the line? Is it age-dependent? Is your nadir the most important indicator of how far you will able to improve later? Does it vary greatly from individual to individual? At what point you would not expect further recovery?
Thanks a lot. Be well.
Response from Dr. Holodniy
Recovery of CD4 count does depend on how low the CD4 count was when treatment was started, age, and other factors like other medical conditions including other ongoing infections. In general, the greatest increase occurs in the first year after HIV viral load becomes undetectable. A smaller increase can still occur over the next few years. Since we usually don't obtain CD4 counts before someone is HIV infected, we don't know what the CD4 count would normally be, as the normal range varies from 500-1500. Some people do achieve CD4 count increases and can maintain CD4 counts in the normal range after starting HAART, whereas those with CD4 counts < 100 at the time of starting may not get back up to normal range, but still achieve sustained increases >200 to get them out of the danger zone of developing serious infectious complications.
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