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cd4 count and therapy
Apr 27, 2005

To Doctor.., first i want to thank you you and this website..it's so much useful for positive people..,I just know that i'm positive last month and my cd4 i got it test last week is 280,11% i just got the result today and i wonder if i should the therapy now or wait until it's lower 200..i'm confuse about the limit of cd4,today my doctor told me that my cd4 is still fine (?)..,but i think it just 11%..i've read in another website where they wrote that should take madication if our cd4 is lower than 14 % or 200..,i'm starting to get sick now..diharhia,rashes,fever and caugh..,i'm going to see my doctor again next week..so i need to decide if i should take it now or wait until 200 of cd4 like my doctor said.., Thank you so much..,

Response from Dr. Sherer

Most international guidelines agree that all patients with HIV-related symptoms, such as prolonged diarrhea and fever should be treated with antiretroviral therapy (ART). For this reason alone, I would suggest that you and your doctor consider starting ART right away.

The US HHS guidelines recommend considering ART in patients without symptoms when the CD4 count falls below 350 mg/dl, and/or when the viral load exceeds 100,000 copies/ml. And all guidelines agree that patients with a CD4 cell count below 200 cells/ml should be treated. So your level is quite near the absolute threshold for treatment, and certainly at a level where treatment can be considered, in my opinion.

Finally, I agree with you that the CD4 percentage of 11% is somewhat lower than expected, as a CD4 cell count of 200 generally corresponds to a CD4 percentage of 14%. I would also consider this value in the consideration of ART in your case, and repeat these tests promptly.

Finally, I would take this question to your physician, who has far more specific information about your case than I do, and discuss your options with him or her.


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