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persistently low CD4, but is it a problem?
Oct 28, 2009
Hi Joe,
Another question for your fine self.
I've been undetectable for over a year (yippee), but unfortunately my CD4 count has remained around 170 for this time. My percentage is not too bad at around 22%. My current combo is DRV(r) and Truvada. A few months ago my counts were 155 with a percentage of 32. I was taking AZT, with a slighly different combo, and when we dropped AZT, the CD4 count shot up to 204 (my highest yet) although the percentage dropped to 19 from 32! My latest figures are disappointing because I reasoned that AZT was causing a cealing on CD4 count, and expected to be around 240 not 176. Can you explain this? Finally, despite the apologetic numbers I am physically in top form and because I've been undetectable for over a year my consultant is not worried about opportunistics. However my concern is the increased risk from malignancies. Am I right to worry about this? Can one live with a persistently low CD4 count for a long time without developing malignancies?
Thanks again for your time.
Regards,
Michael.
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Response from Dr. McGowan
Thanks for your question.
I think you may have listed the CD4 % wrong...it sounds like the CD4 % dropped from 32 to 19, if that is correct. If so it may be important to know if the initial count had been confirmed..that is, did you have a couple (or more) measurements with the % around 32 or was it just one? Often there is variability in the lab so it is good to have a couple of numbers to confirm...having a total CD4 count of 155 with a % of 32 is not usual (generally you would expect a much lower % - perhaps 12-14- with that level of CD4).
Be that as it may. Having an undetectable viral load is definitely a benefit and gives you protection against disease. The worst situation is having a low CD4 and a high viral load, the best is having a high CD4 and an undetectable VL, the next best is an undetectable VL with a lowish CD4. If that first CD4% was an error than your % has increased from 19 to 22 which is very good. I think you should give it time...these numbers may take a little while to improve.
The good news is that all those new CD4 cells that your body has made over the past year are free of HIV---yippee!
Joe
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