hi dr bob, my partner and i have both found out recently that we are hiv positive and his initial blood count came back yesterday with a cd4 of 110 (the test was last week) last night he was really hot,too hot to cuddle in winter even,we dont know who had the virus first, but is it possible to have such a low cd4 at seroconversion? he also coughed so much he vomited this morning. dr has said that we wait for a specialist to fly up to our area before he starts taking meds and thats a 2 week wait, im really worried about him now and wondering what you opinion would be becuase the not so specialists are indicating that we should sit tight and wait for the hiv guru to get here, but from my reading so far this looks nasty and more serious than its being treated. plus the sexual health clinic for the local area are afraid to shake our hands or accidentally touch us when we exchanged a app. card! thankyou

Hi,

It's doubtful the CD4 count would drop to 110 during seroconversion. More likely your partner has been infected for a very long time (years).

A specialist has to "fly up to your area?" Where the hell do you live? Siberia? Iceland? The Arctic Circle?

If your boyfriend is febrile, vomiting and coughing with a CD4 count of 110, he needs to be evaluated now, not in two weeks! Your local poor-excuse-for-physicians should evaluate your buddy now, even if they need to call a "real doctor" on the phone to walk them through the evaluation and treatment plan.

The sexual health clinic staff is afraid to shake hands with you??? YIKES! Hmm . . . have you guys ever considered moving to a more reasonable (and compassionate) locale? You're both going to need competent (and hopefully compassionate) HIV/AIDS care going forward. It seems your current community is sorely lacking in both competency and compassion. I'd get the hell out of there (if possible) and not look back. I think your partner may have written to me yesterday. I'll repost that response below.

Good luck to you both.

Dr. Bob

CD4 count of 110 and just diagnosed. Jun 10, 2009

Hi doc my names chris im a 22 yr old male who just found out im HIV positive. Went to the doctor today for my intial results and he instructed me that I had a CD4 count of 110 he didnt have the viral load on record. Iv'e been smoking since I was 15 and have been drinking lots of grog to deal with the stress. My fiance who is also hiv positive has a cd4 count of 800. Am I a gonner cause its so low. What the hell do I do. Thanks doc Ps: will my low cd4 count increase hers if we make whoopie :)

Response from Dr. Frascino

Hey Chris,

Sorry to hear about your recent diagnosis. Are you a goner because your CD4 count is 110? Nope. But you do have AIDS with severe CD4 depletion that places you at increased risk for opportunistic infections, such as PCP (Pneumocystis carinii pneumonia) and consequently you do need to take action now!

As for what to do next, here's what I recommend:

1. See an HIV specialist physician without delay. That doctor will want to do additional tests, including repeating your counts and getting a resistance (genotype) test to help decide which antiretroviral medication regimen would work best for you.

2. Clean up your act. That means stop smoking, cut back on the grog and decrease the stress in your life. Improve your nutrition and get adequate sleep, rest and exercise.

3. As for making whoopee with your HIV-positive fiancé, use condoms. You don't want to risk cross contamination by picking up each other's viral strains (dual infection/superinfection).

4. Because your CD4 count is below 200, you should immediately begin prophylaxis for PCP by taking Bactrim (Septra) daily.

5. Get informed about HIV and its treatment. Begin by reading the "Just Diagnosed" chapter that can be found under the "HIV Basics" heading on The Body's homepage. From there you and your fiancé should peruse the wealth of information in the archives and on related sites.

With proper and prompt treatment, you could experience significant improvements in your CD4 counts and consequently your immune health.

Good luck.

Dr. Bob