Unusually High CD4

Question

Hello Dr. H, I tested HIV+ almost 10 years ago. After starting HAART, I have consistently had extremely high CD4 counts, typically ranging from 1850 to 2600. At the same time, my WBC is normal and my CD4/CD8 is normal. Also, the CD4% has typically been WNL, ranging from 40-48%,

Since starting the ARVs, I've been undetectable. The two doctors I have seen over the 10 years have never really understood how the CD4 can be so high, as it is often an indicator of some other underlying disease, they've stated. However, they cannot figure out what, or if this is just some bizarre way my body works. What is your opinion on this? THank you for your assistance.

============ These are the results over last 3 years:

CD4 Absolute Count, 355 - 1426 /cmm 1815 1549 1730 1703 1770 1844 2046 2307 2458 1915 1974 2153 2177 1935

Answer

We occasionally do see this kind of response, but how many people have significantly elevated CD4 counts with HIV infection is unknown. Sometimes people do overshoot the CD4 count response after starting HIV treatment. This kind of sustained elevation has also been seen in people with HIV infection who have had their spleen removed. Rarely, this can occur with certain kinds of malignancies, but something would have shown up in your blood smears or on examination by now if this was an issue. In general, this does not cause any harm.