CD 4 count viral load

Question

hi Doctor, I was diagnosed HIV Positive in April 2013 at that my CD4 count was 424 and a viral load was not done, I have just had my next lot of tests 3 months later, my CD4 count has gone up to 595 and viral load was 8000, I figure I contracted HIV last August as I has a very bad flu which at the time my GP thought was swine flu and prescribed tami flu, I now realize it was most likely the onset of the HIV virus which I contracted from my husband unknowingly, he was also diagnosed April this year with a CD4 count of only 29. Can you advise me where I am in grand scheme of things and if its a good thing that my CD4 count is going up without meds? I don't live in the USA and we only can receive treatment here once our CD4 count drops to 300. I am a really healthy person who seldom gets ill at all most of my life I have been this way and maybe need to see my GP once in four years(well before this that is). I look forward to hearing from you, as I would like to know is it normal for CD4 to go up unaided by medication?

Answer

Your current CD4 count is in the normal range (500-1500) and your HIV viral load is in the low to moderate range (range 20-1 million copies/mL). You could have had a modest increase in CD4 count after acute infection. Current guidelines in the US recommend starting HIV treatment, regardless of the CD4 count, after someone is diagnosed. Previously, the recommendation was to start HIV treatment when the Cd4 count went below 350. Recent data suggests that waiting results in more destruction of the immune system over time. That said, in your situation, you are in pretty good shape now and could afford to wait. It will be important to see what your numbers are doing over time. If they remain steady, then your immune system is doing a relatively good job on its own. If you start to see your CD4 count and percent declining then you know the virus is winning and HIV treatment (if you can get it) would be important to start.