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Does HIV need CD4 to survive

Sep 2, 2001

I would like to know if there are cases where someone who is HIV+ but not detectable having an extremely low but stable +/-300 cd4 count as a defense against HIV not being able to replicate itself. (What I mean is that HIV needs T-cells to survive. What if T-cell counts are low thus the virus also cannot replicate as much) Only when someone does not feel so good the T-cells go up, beat the disease causing this & then dropping again to +/- 300, all while VL remains undetectable?

Response from Dr. Holodniy

There may be a couple reasons for undetectable viral loads and CD4 counts in the 300s. First, a person was infected with a slowly or defective replicating viral strain. Second, they could have a very good CD8 (cytotoxic t cell) response against the virus. Infection in someone who had boderline low CD4 count (500) to begin with, could explain the stable, but lower CD4 count now, especially if they have a good CD8 response.

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