CD4 Cells - Macrophages - T Cells
Editor's note: The indications on this page for the beginning of HAART are wrong and it was a problem to expect health declined to such an extent (today I see how disgusting it was) that we were facing life risks or being very close to passing .
The START study confirmed that antiretroviral therapy (ART) should be started as soon as the diagnosis is made. It remains here as a living document of the errors that Cietists have commented on and God knows how many people have died wretchedly in such an irrational way.
CD4 cells or macrophages (sometimes known as T-cells or helper cells) are the white cells that organize the immune response of your body; if your system immune system was compared to an army - and this nomenclature would suit him very well - these cells could be known as the generals of his immune system.
The counting of these cells is to measure the amount of them, the CD4 cells, found in a milliliter of blood (a very small portion of the blood), and not your whole body, as you might think; this analysis parace be insufficient and, however, is more than enough to analyze the condition of your immune system. Your doctor probably will refer to them as a number; for example, 498.
The count CD4 cells in a person not infected with HIV and may vary between 500 1500. However, CD4 counts can vary greatly from individual to individual. Your own count CD4 can vary greatly due to many factors, for example:
- Women generally have higher scores than men CD4 (about 100).
- Count CD4 cells usually oscillate up and down depending on your menstrual cycle.
- Oral contraceptives tend to lower the count CD4 women.
- Smokers tend to have a count of CD4 than nonsmokers (about 140).
However, none of these factors seem to influence the immune response in humans.
Only a small proportion of cells are CD4 in your bloodstream. The rest of them remains between organs such as spleen, and lymph nodes. Variations in CD4 count may occur due to such migration between the blood and body tissues.
So, rather than give too much importance to a single examination. The ideal is to make a measurement on the count CD4 in small intervals, and these intervals are much smaller, the better. And yet, if you are not feeling well or are having an active infection such as herpes or flu, you'd better ask your doctor to delay a little collection of material until you feel better. If you get a very different result than usual, and no matter whether it be for better or for worse, ask your doctor to repeat the test to see if there was a mistake in the lab.
Soon after HIV infection, your score will probably CD4 fallen sharply before stabilizing. Even when you feel well and there is no apparent sign of HIV infection, millions of cells of this type are being invaded and lost every day, and millions more are being produced to replace them. Without treatment, an HIV positive person will lose gradually, and these cells will, on balance, a decrease in cell count CD4 and another fall, this, the quality of the immune response.
A score of between CD4 200 500 and indicates that some damage has been suffered by your immune system.
It is particularly important to monitor your score CD4 until it approximates 350 cells per milliliter of blood
Monitoring cell count CD4
It is recommended that you take two exams count CD4 if you are newly diagnosed with HIV infection. These results serve to provide a basis on their health situation, so you and your doctor can monitor future changes. These tests usually occur the first time you visit the infectious disease and, three months later, when you make your return visits.
If you have a relatively high without symptoms CD4 count and are not taking antiretroviral drugs, their count CD4 will be monitored every three or four months, or even every six months, if it is very high.
However, if your count is dropping fast CD4 or approaching levels where it is recommended to start treatment (currently in 350 for most people) or if you are participating in a clinical trial, your doctor may suggest, and will be clever of you to accept that your count CD4 be monitored more frequently.
After you start your treatment with antiretroviral drugs, you will often count a new CD4 about a month after you start treatment, and every three months. Once you have your undetectable viral load (see Viral) and its CD4 count starts to rise, your doctor may suggest that the count is done every three months and then every six months. You can have the focus of your expectations, there will be an increased frequency of testing if your score stop climbing if you show symptoms or not feeling well.
The monitoring its count CD4 will help you and your doctor in making important decisions in caring for your health in general and HIV treatment, do not let go of it
Count CD4 above 350 - monitoring and early treatment in some circumstances.
If your score is above CD4 cells 350 and you are without symptoms, you probably do not need to start treatment now. But his count CD4 be maintained with regularity every six months. When your count cd4 start approaching 350 may want to monitor this more closely, every three months, for example, or even smaller intervals.
In some situations your doctor may determine that you begin treatment with antiretroviral drugs even if your score is above 350. These options include:
- IF you are coinfected with hepatitis B or C, for liver diseases worsen if the count is low CD4.
- If you have kidney problems.
- If you are in treatment for cancer.
- If you have a relatively advanced age (over 50, for example).
- If you want to get treatment, why be concerned about the possibility of transmitting HIV to someone (treatment significantly reduces the possibility of transmitting the virus).
- If you are ill because of HIV infection.
- In some cases, it is clear that you recently acquired HIV.
Count on CD4 350 - Starting HIV treatment
If your count CD4 drop to or near 350 350 is usually common to start HIV treatment. It has been shown that starting treatment with counts CD4 around 450 brings a number of advantages that started with CD4 in lower scores.
The immune system recovers more easily and quickly when treatment starts with counting CD4 around 350.
Starting treatment with counting CD4 around 350 creates a condition where you hardly get sick because of HIV. It is also shown that starting HIV treatment on this count, reduces greatly the likelihood of you developing serious diseases such as kidney or liver diseases, as well as some cancers.
Your doctor will talk with you about the start of treatment when the count CD4 approach 350. At this stage of treatment you will have more frequent exams CD4.
Count on CD4 200 or below - immediately start HIV treatment and prophylaxis for other diseases
If your count CD4 Stow in 200 or below it is essential that your doctor start HIV treatment immediately. A count of CD4 these levels is an indication that you are at serious risk of developing serious diseases known as opportunistic diseases.
Therefore, you should also start taking other medications such as antibiotics, to prevent the emergence of these diseases; this is called chemoprevention. The type of chemoprophylaxis you will get will depend on your score CD4. Only your doctor, not you, is able to tell when you can stop safely to chemoprophylaxis. This occurs generally when the count rises above CD4 200 and remains, while above this.
For example: You may receive antibiotics (such as Bactrim or Dapsone) to guard against PCP, a dangerous type of pneumonia.
You may have to do other tests to assess their clinical / medical condition. Issso may include tests to assess illnesses and conditions, and may include tests for tuberculosis (TB). In countries like Brazil, with high rates of tuberculosis, you will be tested anyway
His count CD4 when you are being treated for HIV
Once you begin treatment for his HIV viral load will begin to fall and is expected to count CD4 climb gradually. The rate of growth varies from individual to individual and depends on many factors. In some people are required months and sometimes years for the count of cells cd4 rise to normal levels for the age of the person. In general, the lower the viral load is when you start treatment, the longer it takes for the immune system is completely recompose. But it's good that you understand that even the slightest change in your CD4 count, up, brings huge benefits to your health
Your doctor will monitor your viral load and count your CD4 for three months until it normalizes. Once your viral load becomes undetectable and his CD4 cell count starts to rise, your doctor may suggest (and it is up to you to accept or not) that the monitoring of these paths pass for longer periods, for example, every six months ..
Percentage of CD4
In addition to counting and monitoring the count CD4 some doctors sometimes make the measurement of the ratio of how many white cells are CD4 (There macrophages, TK, CD8 cells and others, all with definite and important functions for your health). Called CD4 percentage of cells. Although this system mensuramento white cell is not the most appropriate for monitoring the health of the immune system of adults, there are situations where this measurement is useful.
For example. If your count is very different from CD4 percentage CD4 can be an indicator of other health problems
Another situation where this comparison is useful when there is a wide variation between the count and the percentage of CD4 CD4 because there may be some kind of lack of harmony in these paths and this can be a warning sign that bigger problems may be about to occur, and thus the doctor may order additional medical tests, as for the people says, nip it in the bud.
It is very important that cd4 cell counts are done regularly.
A note from the Editor in March of 2018. Since 2017 we have done, we, people living with HIV, only the examination of viral load, since rarely, when the patient keeps with correction the most important ADHERENCE TO THE TREATMENT, WHICH SO RARELY OCCURS AN ABRUPT AND IMPORTANT FALL OF COUNTING OF CD4.
We have periodically done only the measurement of the viral load and, if it goes up, a new measurement is made, in order to effectively give notice of possible therapeutic failure or was,just a viral blipe“
The Original you find here.