Recent infection but low CD4 Count

[jdman]

I recently tested positive, and I am quite certain that I was infected in June 2012. (I tested negative in April, and about every 6-9 months prior to that.)  I've had three viral load and T Cell panels.  The first two were before going on medications - viral loads around 4,000, which I understand is not high for not being on meds.  The last test, 3-weeks after starting meds, was 90.  I feel good about that.  Also, I haven't been sick other than having a mild chest cold about the time I tested positive.

The problem is my CD4 count.  The first test was 111 (13%).  The doctor thought that it must have been a fluke, so did the second test, which came back at 61 (14%).  Based on that test, he put me on meds even before the genotyping results came in.  After three weeks of meds, the viral load dropped nicely, but the CD4 count was only 110 (13%).

For now, I'm on two types of antibiotics to prevent certain opportunistic infections.

My doctor is baffled about the low count, which would normally reflect someone in the later stages of infection.  I talked to another doctor on the side.  He thought it could have been that my CD4 count was knocked way down from the initial infection, and that my body might just be slow to rebuild the count.

Has anybody seen a seen a situation like this?  I feel like I have every advantage in dealing with this (early diagnosis, good insurance, no other health issues, no addictions, great social support).  How can my CD4 counts be so bad?

10/20/2012 Tested positive
10/24/2012 Viral load ~4000, CD4 111 (13%)
11/7/2012 Viral Load ~4000, CD4 61 (14%)
11/16/2012 Started medications (Truvada, Reyataz, Norvir)
12/10/2012 Viral Load 90, CD4 110 (13%)

[Common_ground]

Hi Jdman and welcome to the forums.

I have similar numbers and can see where your coming from.

I was bummed out when I got my first reading and it was equally if not more shocking than the poz diagnosis. Good thing is that even you have a a somewhat low cd4 count, your not sick at the moment, so cherish that.

Keep us updated on how things progress.

Best, CG

[tednlou2]

Welcome to the forums, although I hate that you had to find us.  I know with acute infection, CD4 counts can plummet.  I have read (the more knowledgable folks can chime in) is that someone in acute infection with a CD4 of 100, for example, is not the same as someone infected for a while with that number.  The newly infected person still has an immune system very much still intact. 

I admit this is still an area I need more education.  I am not sure whether someone in acute infection would be expected to get the same infections as someone living with the virus for some time, with those same labs.  Most of have no idea what our labs were prior to infection, or what our counts were doing in the time between infection and diagnosis.  I was diagnosed 7 years after what I believe was my infection.  My CD4 could have dropped to 10 at some point, especially during acute infection.  I have no idea. 

The good thing is your now on meds and from my take on your post, you seem to be happy with that decision and you're not looking back.  You're just curious about the low count so soon after infection.  I will be interested as well to hear what others have to say about counts in acute infection or soon after infection, and how much a difference there is between a new infection with those numbers vs an older infection.  I do know that our counts often drop dramatically and the viral load is very high in acute infection, but most regain many of those CD4s and have a lower viral load for a period of time, depending on genetics and viral strain.  And, it often takes 6 months, before our bodies get a handle on the virus and things start to level out. 

[Anqueetas]

Hi Jdman and welcome to the forums.

I have similar numbers and can see where your coming from.

I was bummed out when I got my first reading and it was equally if not more shocking than the poz diagnosis. Good thing is that even you have a a somewhat low cd4 count, your not sick at the moment, so cherish that.

Keep us updated on how things progress.

Best, CG

Cheers CG, you seems fine to me when we met. Normally you never know what was you initial CD4 pre-infection. It might be that you naturally have low CD4 to begin with, what matters is that you feeling good and don't get sick.

[Fisher]

JD:

Although I know it is next to impossible, do not freak out. It is highly likely you are very ok.

The trick is getting the VL to UD.  You are well on your way. My doc at MGH, an acclaimed reseacher since the start, mentions that it usually takes about 12 weeks to get to UD.  More important the CD4+ count lags behind, but will rise.

If you look at my history, while my CD4+ count is a little higher, the percent is 13%, not anything like my past or what I like or want. But I have complete and full confidence that it will rise, the percentage and the CD4+.

Try not to go crazy. Easier said than done.  But please trust that time heals and things will turn out well.

[mcalobr]

I am in a similar boat, in that I was recently diagnosed, but I have a low CD4 count.  I  am still waiting on my viral load, but I was really not smart, and I didn't protect myself...what's worse, it's been a few years since I was last tested, so I don't know how long it's been building up. 

I am happy to be getting treatment now...I guess I finally just grew up and found some self worth.

Thankfully, that is the only number that appears out of ordinary so far.  My CBC looked great...I just want to get on meds asap now...