Been told my Tcells won't go up

Question

I looked but could not seem to find the answer to this question. I am 48 and have never had any serious health issues all my life and I don't smoke, drink, or do drugs.

I tested positive September 2004. My VL was over 100,000 and my Tcells were at 305/31%. The doctor said I was probably infected for 2 years or so. (My last test was 2.5 years before.) I was never sick from HIV before that or since then. I started Combiver and Sustiva right away with no side effects and in 6 weeks my VL dropped to 536. Two months later it was down to 157 and my Tcells were up to 387/43%. three months later, (my last labs), my VL was down to undetectable and my Tcells were up to 500/41%. I am thrilled but this is what I am confused about. The doctor said my Tcells will probably not go much higher. That devastated me and why is it that they will not go higher? He has said that probably very little damage, if any, was done to my immune system. I know guys who were down around 200 Tcells or less and are up close to 1000 now. Why won't mine go back up, especially if they were only down to 305? Also, how could I have had 387 and it be 43% and now this time 500 but it is only 41%? Thank you

Answer

Where you get to is a function of where your normal CD4 count was and how low it was when you started HIV treatment. We usually know the second number. But since none of us ever know what our CD4 count is before becoming infected since it is not a usual test obtained at a routine doctor visit, it is hard to know what is normal for you. The normal CD4 count range is 500-1500 in uninfected people, so you are there.