How important is a CD4 count?

[Jerry71]

My doctor only takes a CD4 count from me every other visit? My numbers have always been below 200. My VL has been undectable for sometime now. Just think it is strange that they would only take my CD4 count every other visit.

So the question is what is more important a CD4 count or a undectable VL?

[dixieman]

cd4 count is very important but, if your viral load is undetectable it shows the drugs are working. Generally the cd4 takes time to rebuild slowly so your doctor must think its not necessary to check as often when your viral load is still non-detectable. Why not ask your doctor? are you on state funded programs? it may also be a money factor... so your doctor opts for a more reliable factor with your case... viral load... shows if the meds are working...

[woodshere]

For the longest while my CD4 lagged in the 200 range and I would always bitch about it not improving more quickly.  His response was that CD4 counts that are initially low take longer to improve, but the most important thing is that you are undetectable.  I would say this is a cost saving measure.

woods

[Miss Philicia]

I thought you already had a thread about this issue.  It seemed in the other thread that there was a distinct consensus that it was VERY ODD that your doctor would only check your cd4 count every eight months, certainly at the numbers you are currently at.  In fact, I find it odd at ANY cd4 count.  Furthermore you need to have the cd4% monitored, and it's the same test as far as I know.

Mine are +1,000 currently and they are still checked every 3 months.  I also went 12 years where they were checked at least every 2 months when they were much lower, and every month when they were at a <200 level, though I will admit that was before current combo therapies were available.

I don't see how it's a cost saving measure really.  That's an odd statement.  One can view anything as a cost saving measure if you just decide not to do it.  As far as I know the test for cd4 is much cheaper than a VL test anyway.  Plus they should be doing blood test for all the "normal" stuff like lipids, triglycerides, etc.

[leatherman]

For the longest while my CD4 lagged in the 200 range and I would always bitch about it not improving more quickly.  His response was that CD4 counts that are initially low take longer to improve, but the most important thing is that you are undetectable.

In over 10 years of meds, only once have my cd4s ever gone over 300 (and then only to 311, before falling again). The only times that I have been really sick with low cd4s, I also had a very high VL. I used to worry about this; but since I seem to able to survive and live fairly healthy in the 200 range for all this time, my doctor and I both agree that keeping the VL undetectable is the most important thing.

I will add though, that each time I have blood work done, they check cd4, VL, lipids, etc. (If my VL is undetectable I get labs every 3 months, otherwise it's every month until the VL is back down 2 or 3 months in a row.)

[blondbeauty]

The only thing meds do is stop the replication of your virus. So the only way to know if your meds are working is doing a viral load test to make sure it remains undetectable. CD4 rise naturally without the presence of HIV. If your cd4 count is above 200 it is unlikely you can have any AIDS related complication. So you don´t really need to have your CD4 tested every time. But if they are under 200 and you are on bactrim or other preventive antibiotic you should have a cd4 count test every time to stop bactrim (or other antibiotic) as soon as they rise over 200.
My Dr considers that because I started meds over 500 cd4 nothing can happen provided my viral load is undetectable every time, which means meds are working and there is no resistance. Other Drs. in the same hospitals perform CD4 counts every time. Think that you save a tube of blood. A regular blood test requires 2 tubes: hematology and biochemistry (cholesterol, liver and kindney functions, etc.) + another tube for the viral load + another for cd4 counts. This last time they needed five. The Dr ordered aditional tests. I will find out in two weeks.