Danger of chickenpox with CD4 count in low 200s

Feb 2, 2013

Hello, I have been treated for just over two years and finally have a CD4 count in the low 200s, CD4% around 15, undetectable viral load. I have never had chickenpox as a child. My initial CD4 count was very low, 14, and I'm told my body lost memory of most of my childhood illnesses anyways, even the ones I have had, so that may mean I could get any of them again. Concerning chickenpox, how dangerous would it be if I were to be unlucky enough to be infected by it? Can someone with such a low CD4 count survive it? Thanks

Response from Dr. Young

Hi and thanks for posting.

Chickenpox is very common in the general population- most, like you have had the infection early in life. It's very rare to see someone loose their chickenpox immunity and a second "first" infection shouldn't happen.

The principle issue with chickenpox is the reactivation of the virus- known as shingles or herpes zoster. This can be a bother for many people, and more common among people with low CD4 cell counts. Shingles occurs not infrequently in our clinic population, is usually not serious or life threatening, but certainly a cause of a lot of unhappiness and the risk of residual pain.

While there is a vaccine to prevent or minimize shingles, it's not yet approved for use in people living with HIV (especially those with CD4 counts around 200).

Shingles can be treated with medications, and their use is optimal if started at the onset of the recurrent blisters. Should you develop symptoms of shingles or chickenpox, the thing to do is to contact your care provider immediately- and ask for evaluation for this complication.

I hope that helps, BY