Q. I am newly diagnosed and have digestive problems? I tested positive last week and my CD4 is just above 1200 and my viral load is 94. My doctor said there were no other infections. Now I am having a problem with my digestive system…it is inflated with light abdominal pains. I am worried of conflicts between my HIV status and my digestive system. What should I do? A. I’m sorry to hear about your recent diagnosis. This is all very new and you are probably still trying to take this in. Finding out you have HIV can be tough. Could this have helped him keep his CD4 count higher?
different doctors and experts interpret the same studies differently.
A.
For example, in someone who is otherwise healthy, UK guidelines recommend starting treatment when your CD4 count is about 350. Some US guidelines recommend starting when the CD4 count drops below 500 and others to start at any CD4 count if the person is ready for treatment.
It is easily possible that your husband could have been HIV positive for many years. There is no way to know this now but there is a wide range of individual response to HIV. Some people keep a CD4 count above 500 without needing treatment for 5 or 10 years. For others, their CD4 count can fall more quickly needing earlier treatment. Unfortunately, many doctors do not routinely offer patients HIV testing, especially if they don’t think they might be in a high risk group. This often leads to people being diagnosed late. In this case, it is good that your husband was been diagnosed early enough to get such a positive response to treatment. The gym will have helped keep him keep fit and this is good for general health, but it is not likely to have helped his CD4 count. Q. Can you start treatment with a CD4 count in the normal range? What is the outlook for someone who is HIV positive and whose CD4 count is still within the normal range? What is the advice about to starting ART?
There is strong evidence of health benefits once your CD4 counts are below 350, less evidence of benefits when starting at 500. There is very little evidence that the benefits outweigh the risks for anyone with a CD4 count above 500, although there are plausible reasons for why earlier treatment might be better. The START study will provide good evidence on whether earlier treatment is better, but results are not expected for a few years.
Your doctor or clinic should include counselling and contact details of support groups. Speaking to other people in a similar situation can give you comfort to know that you are not alone. It can also let you share experiences and listen to how others have coped. Finding out you are positive can be stressful. It can stop you sleeping properly and the worry can cause other symptoms. It is normal to think that every time you feel unwell this is connected to HIV. But, as your immune system is strong - and a CD4 is above 500 is considered ‘normal’ – it is not likely that HIV is directly causing abdominal pains. However, as with any symptom that you are worried about, this is something to tell your doctor about so that you get appropriate medical advice.
In the UK, you can start treatment at any CD4 count if you want to use treatment to reduce the risk of being infectious to sexual partners.
A. The normal range of CD4 count varies depending on which make of test is used. This is generally between 400 -1600 for 95% of HIV negative people. A small percentage of people will have higher or lower CD4 counts and this will still be normal for them. Guidelines recommending when to start treatment vary depending on which country you live in. Some countries have a higher cut off point than others, because POSITIVENATION.co.uk
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