What could cause a low CD4 count in an HIV-positive person?
Patient's Query
Hi doctor,
My father was diagnosed with HIV-1 (Human Immunodeficiency Virus) five years ago. His initial CD4 count was 110 cells/mm3, and his viral load was 100000. After consulting the doctor, he started taking ART (Anti-Retroviral Treatment) for six months. After that, his viral load became undetectable, and his CD4 count increased to 450 cells/mm3.
Then, after six months, his viral load became less than 15 copies, and his CD4 count came down to less than 390 cells/mm3. After that, he did a test after three years, and his CD4 count came down to 285 cells/mm3, and his viral load still remains less than 20 copies. Why does he have a decline in CD4 count? Is there anything to be worried about?
He did not do any tests after this. Now he is healthy and has recently recovered from COVID-19. When can he do a test again to get an accurate CD4 count?
Please help.
Hi,
Welcome to icliniq.com.
There is an immunological and virological failure. If there is any resistance to the virus by the current medications, then this is the first virological failure indicated by an increase in viral load, followed by a decline in CD4 count. So, a fall in CD4 count occurs, followed by an increase in viral load. Do tests for viral load regularly. Then the third one is a clinical failure, which represents multiple opportunistic infections.
In your father's condition, a simple decline in CD4 count does not represent any failure, as it is not in line with a fall in CD4 count. So it indicates that there is no failure. It is better to get his latest CD4 and viral load to know his current situation.
Kind regards.
Patient's Query
Thank you, doctor, for the reply.
It has been a month since I recovered from COVID-19. Is he able to get an accurate CD count if he tests it now?
Hi,
Welcome back to icliniq.com.
Their relationships are not yet documented. Both are viruses. COVID-19 (severe acute respiratory syndrome coronavirus 2) does not show any effects on CD4 cells but it affects lymphocytes. So it gets affected indirectly. It is good to wait for the next 45 days.
Same symptoms don't mean you have the same problem. Consult a doctor now!
HIV/AIDS specialist
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