Once you have AIDS by CD4 count-Do you Always have AIDS?

Question

I can't get a straight answer. I hope you can help. I was diagnosed positive in 2004. The doc I had then believed that not starting meds was the best thing to do because of getting medication resistance too early. Between 2004 and 2009, without any antiviral meds, my CD4's ranged between high 200's and high 300's with viral loads around 27,000. Finally, in 2009 my CD4 count dropped to 157. I did not have any AIDS like symptoms at that time, thank heavens. Finally, I changed docs and got onto meds and immediately got results and have been doing well since. My questions is, once you technically by CD4 count, have AIDS, are you always considered having AIDS? Or does it go back to being HIV+ Was I mismanaged by first doc or were protocols different in early 200's? Thanks.

Answer

Hello and thanks for posting.

In brief, yes. If you had a CD4 count below 200 (and percent less than 15), you had an AIDS diagnosis. By definition, once you have an AIDS diagnosis, you always carry that diagnosis, even after your CD4 count (and health) have returned to normal.

The jargon isn't very precise, as with a normalized CD4 count on treatment, your AIDS-related health risks are very low. Unfortunately, there also appear to be certain types of health risks (such as bone disease) that are based not on one's current, but rather lowest-ever CD4 count.

As for your previous doctors and their management, recommendations in the middle 2000's said to start treatment when CD4 counts were either below 500 or 350- depending on the year and country you live in. Today, US treatment guidelines recommend treatment for all people living with HIV, irrespective of CD4 count. If your counts were always below 350, and with your average viral load (that's to say not very, very low), most guidelines would have recommended treatment.

I hope that helps and wish you excellent health. BY