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Low Nadir CD4 Count
Nov 20, 2011

Hello Doc, I'm 39 . My nadir cd4 count was 50 and VL 1 millions when I diagnosed+ January this year. Started Atripla since February until now. CD4 count now 400/20% and VL undetectable ( <40). Are there any records that people with low nadir cd4 count like me could survive for another 10-15 years more? because I heard that people used to have low nadir cd4 count will get related AIDS defining illness in the future even if they have high CD count now and undetectable VL. Thank You

Response from Dr. Young

Hi and thanks for posting.

Sounds like you were diagnosed late in the game, with a very low CD4 count nadir. The good news is that you did get diagnosed before your became really ill and that your Atripla is working terrifically well.

People with low initial CD4 counts can and do live very well- I'd have no reason to doubt your 10-15 year horizon, indeed, I'd be planning for many more years than that. Your focus of concern is not misplaced though. The issue among persons with low CD4 nadirs is an increased risk for a variety of non-AIDS related (not AIDS-related) complications- including, for example, cancers, heart and bone disease appear to be more common (but not inevitable) in persons with low nadirs compared to those with higher initial counts. This is a topic of considerable interest and still of some controversy when it comes to figuring out how best to screen and prevent these newly appreciated medical issues.

For now, I advise that all persons living with HIV (but especially those like you, with low nadir CD4s) to do their best with preventive strategies (like not smoking, eating well, and getting routine health screenings).

Stay tuned, and thanks for posting. BY



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