i-base Q & A Question My CD4 count is 419. Can I stay healthy without treatment? Answer: You can stay healthy without treatment in the short term. With a CD4 count of 419, there is no immediate rush to start treatment. BHIVA guidelines recommend starting treatment at a CD4 count of 350 cells. However, they also recommend considering treatment, at any CD4 count, if you: have an HIV-related illness, are aged over 50, are pregnant, are co-infected with hepatitis B or C or want to protect a partner from infection. A good reason for starting earlier is that you keep more of your immune system. The higher your CD4 count the higher it is likely to reach. Many people have concerns about starting treatment. However, once they start and fit it into their lifestyles, they wonder why they worried in the first place. Answer: Angelina Namiba Question: Should I worry with viral load results of 94 and 114? I’m worried about my viral load. It was undetectable for years but now it’s 94. On a second test it was 114. My CD4 count is 750 and has always been high. I have been on Truvada and Kaletra for more than 4 years with no problem. Am I getting resistance? Answer: It is very unusual for viral load to rebound once it has been undetectable for a year or more. This assumes that you are still taking your meds and not missing doses. It also assumes that you have not started any new drugs recently that could interact with your HIV meds. Without knowing the timing of these viral load tests (were they both close together?) I can only talk in general. However, because viral load tests are not always so sensitive at low levels, your doctor would probably interpret both results to be the same. Rather than worry, have another viral load test done and then discuss the new results with your doctor. About half of increases that stay less than 200 are either lab errors or blips that will become undetectable again without changing treatment. Answer: Simon Collins 44 Winter 2012
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