CD4 count

[Charles.M]

Got blood work results today CD4@143 and CD4/CD8 at 7%. I have been ud for a year and a half and my numbers wont go up? I also did not get the anti bodies from the hep b vaccine (the three shot one). I am scared and starting to think my numbers will never improve and that I am on borrowed time. Can live very long with such low CD4 numbers? I recently had covid but only had mild systoms, though I do experience mild chest pains occasionally as well light cough with some post nasal drip. Going to see doc on the 9th. Not real opptomistic about my future.

[Jim Allen]

hello! Good to hear from you again.

let's tackle your cd4 number first. Being older always means a slower recovery from any problem than when someone is in their 20s or 30s. And some people just take a longer time. While the data shows that most people take about 1-3 yrs to get their numbers into a good range, like most other diseases there are also the outliers who recover faster and other who recovery slower.

It took me 12 years to get above 300. Of course the meds weren't as effective in the mid 90s; but I was consistently on modern meds for nearly 10 years before getting above 300. In the last 20 years since then, my cd4s remained around 350.....until oddly enough about 4 years ago my cd4s began creeping up and eventually reached 700. In the last 2 years though, they have dropped back to 450. It's like a crazy roller coaster ride.

So let's tackle the second issue about cd4s. The cd4 count is not a measure of how effective/strong your cd4s are. It's only a measure of how many. The general consensus is that more cd4s equals better immune response thus better health. but that isn't true either. Some people with high cd4 counts get sick also.

If you've been feeling healthy (and with what you wrote, it sure sounds like you're feeling pretty good), and UD then I say you should feel happy and just keep on enjoying life.

[Jim Allen]

I quoted Micheal's post, it took him 12 years to reach 300 and I know plenty of people who had single digits for many years before they started to increase and it's not a measurement of overall health.

My CD4 count is 719 /40% (see vampire thread) and I would give you some of mine but mine are lazy useless CD4 cells. In short, I end up visiting the hospital & doctor's office far too often but I get on with it and unfortunately, there is no test or cure against lazy CD4s & immune system, but it seems you are doing better than I am. 

Like Micheal said there are various factors at play including genetics, age, stage of diagnosis etc. You are doing well and you are not going to drop dead tomorrow because of your well-controlled, stable and managed HIV status, stop focusing on CD4 counts and focus on things that are within your control instead.

I also did not get the anti bodies from the hep b vaccine (the three shot one)

.

Same here and I've tried it twice, so 2x3 shots, still no antibody.

[Loa111]

I can only offer you reassurance here. It took me well over 2+ years on our meds for my CD4 to get over 200 (I'd an advanced DX originally with a low CD4 22).  I'm now 6 years on treatment & my CD4 is 400 ish, sometimes less like 380 etc. There is nothing I can do about this only take my pill daily. I really don't care anymore, it is what it is.

ID clinic held back on some of the vaccines including the Hep shots until my CD4 trended above 200, so was 6 - 9 months above 200 before they gave me the shots. I think they had to repeat the hep shots too if I remember correctly.

Don't worry, you'll get there in time. Just take your pills daily & try to maintain a healthy lifestyle. 

[harleymc]

From a nadir of 10 cd 4s it took me 6 years to pass 200.

I've not had any AIDS defining health issues since starting ARVs.

[leatherman]

Can live very long with such low CD4 numbers?

the short answer is yes, because cd4s have little to nothing to do with living a long life. But you're saying, "I thought I needed my immune system to fight off diseases to stay alive?" That's true....but the cd4 type cell is only one of 370+ types of cd cells. Even if you're cd4 was zero, your immune system is only compromised, not eradicated.

As mentioned (in my quoted post. LOL), the cd4 count is only a count. It's not a measurement of how well your cd4 works. Clearly your immune system is still working pretty well if you got through covid. Instead of focusing on how many cd4s you have, focus on your overall health. If you're staying well or quickly getting over minor illnesses, you really don't have an issue to be concerned about.

though I do experience mild chest pains occasionally as well light cough with some post nasal drip. Going to see doc on the 9th.

Having just had my husband experience mild chest pain (he had thought he was dealing with acid reflux or indigestion) which turned out to be severe heart artery blockage requiring quadruple bypass surgery, make sure to discuss this issue with your doctor.

Not real opptomistic about my future.

I understand your issue. I lived it for nearly 20yrs thinking death was just around the corner. However next month is my 40 anniversary of living with HIV, so that was a lot of wasted worry. But I'm not unique actually; I'm just one of many people who have continued to live thanks to the advent of triple therapy back in 1995. What I've seen in those 40yrs is that people who don't get HIV meds die and people who do get treated live. Personally, with my well-treated HIV and genetics from my grandmother, I'm planning on living another 40+ years. Any optimism or pessimism you have about your future should be based on the family traits you inherited and not the well-treated HIV that isn't causing you any health related problems.

[Charles.M]

Thanks all for the replies. It is just so depressing seeing my lab results went from 72 to 163 in three months, then dropped to 140's consistently for the last year plus. Its just so very discouraging. Seeing Id doc tommorow. Just down in the dumps over this

[Jim Allen]

They didn't drop, the % is stable and counts are relatively useless. So if you tested your counts three times within the same day the count will be different each time.

I'm sorry to hear that something rather irrelevant has become a focus point and that it's causing you to feel depressed. Perhaps stop looking at your lab results.

[leatherman]

another cd4 tidbit:
your cd4s can change by 100 points in one day. Each result is just a snapshot of that exact moment in time, and nothing else

08/08/23 CD4-163/VL-21/6%
10/17/23 CD4-162/UD/7%
12/25/23 CD4-149/UD/6%
05/28/24 CD4-162/UD/8%
10/06/24 CD4-143/UD/7%

actually what your results show is that your cd4 count is pretty darn stable with the percentage slightly trending up.

Perhaps stop looking at your lab results.

the hardest advice to take in the early years and yet the best piece of advice you could put into practice. As people living with HIV all we can do is take the meds to reduce the amount of HIV. Everything else, BP, pulse, cd4 count, etc. rises and falls on your genetics, age, comorbidities....and time.

[Tonny2]

M.           ojo.             @Charles.M, we are here for you!!…please focus on your  VL which indicates that your treatment is working. Forget about your soldiers (CD4) right now your soldiers are not fighting HIV so they can recover whenever they feel like going back to work… Hang in there, you are going to be fine… Hugs.