Dr. Kiran Anaparthi
HIV/AIDS specialist
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My father was diagnosed with HIV1(Human Immunodeficiency Virus) before five years. 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 got increased to 450 cells/mm3, and then after six months, his viral load became less than 15 copies and his CD4 count came down 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? He did not do any tests after this. Now he is healthy and recently got recovered from COVID-19. When he can do a test again to know an accurate CD4 count?
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 for knowing his current situation.
Patient's Query
Thank you doctor,
It has been a month since getting recovered from COVID-19. Can 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.
Patient's Query
Thank you doctor,
How often we need to do tests for viral load and CD4 counts?
Hi,
Welcome back to icliniq.com.
We need to do tests every six months.
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HIV/AIDS specialist
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