CD4 count not getting over 200

Question

Please help, I was diagnosed in 2000 and started treatment the same year with CD4 count of 22 and currently the CD4 count is still at 77. My doctor says CD4 counts really aren't that important and that keeping the viral load undetectable is the important factor. So should I just be happy with the situation or should I insist on maybe looking into more drug treatment to get CD4 count up. I will be confortable to see at least reaching 200 but I just seem not get there. I feel fine and healthy, but I guess I am just concerned about my CD4's. What advise can you give.

Answer

I certainly understand why you would like to see your CD4 cells increase to greater than 200 cells/uL. However, your provider is correct that most people with undetectable levels of virus, regardless of CD4 cells do not develop complications. Furthermore, CD4 cells do tend to gradually increase over time in those with good viral suppression.

There are probably many reasons why in some people CD4 cells increase more than others in the presence of good viral suppression. What to do about it is less clear and there is no specific strategy that I or anyone else can recommend. I encourage you to continue to discuss this with your provider as you watch these numbers closely. But do not be discouraged and keep up the good work taking your medications.

Best, Eric