What are CD4 Cells? And How Is The Evolution Of HIV Infection For AIDS?
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 taking a life risk or being very close to passing .
The START study has proven that antiretroviral therapy (ART) should start as soon as the diagnosis is made. It remains here as a living document of the mistakes that scientists made and God knows how many people died so unfortunate in such an irrational way, victimized by AIDS Clinically and Scientifically Conscious.
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 you very well - these cells could be known as the generals of your immune system.
The CD4 Cell Count alerts us on The evolution of HIV infection to AIDS
The count of these cells is the measurement of their numbers, the CD4 cells, found in a milliliter of blood (a very small portion of the blood), not your whole body, as you might think; this analysis seems to be insufficient and, in the meantime, it is more than sufficient to analyze the condition of your immune system. Your doctor will probably refer to them as a number; for example, 498.
The CD4 cell count in a non-HIV-infected person may vary between 500 and 1500. However, CDXUMUMX counts can vary greatly from individual to individual. Your own CD4 count can vary greatly due to several factors, for example:
- Women generally have higher scores than men CD4 (about 100).
- CD4 cell count usually oscillate, up and down depending on your menstrual cycle.
- Oral contraceptives tend to lower the count CD4 women.
- Smokers tend to have a higher CD4 count than non-smokers (around 140).
However, none of these factors seem to influence the immune response of humans.
Only a small proportion of CD4 cells are in your bloodstream. The rest of them remain between organs such as spleen and lymph nodes. Variations in the CD4 count may occur due to these migratory movements between the bloodstream and body tissues.
Therefore, rather than attaching much importance to a single exam. Ideally, a CD4 measurement should be done in small intervals, the smaller the intervals, the better. And in the meantime, if you are not feeling well or have an active infection such as herpes or influenza, you'd better ask your doctor to delay the collection of the material until you feel better. If you get a result that is very different from usual, and it does not matter if it is for better or for worse, ask your doctor to repeat the exam to see if there has not been an error in the laboratory.
Soon after HIV infection, your CD4 count will probably have dropped dramatically, before stabilizing. Even when you feel good and there is no apparent sign of HIV infection, millions of cells of this type will be invaded and lost every day, and millions of others will be produced to replenish them. Without treatment, an HIV positive person will gradually lose these cells and there will be, on the whole, a drop in CD4 cell count and another fall, this, on the quality of their immune response.
A count of CD4 between 200 and 500 indicates that some damage has already been suffered by your immune system.
It is particularly important to monitor your CD4 count until it approaches 350 cells per milliliter of blood
Monitoring the CD4 cell count
It is recommended that you take two CD4 counts if you are newly diagnosed with HIV infection. These results serve as a basis for your health situation, so you and your doctor can monitor future changes. These tests usually occur the first time you visit the infectologist, and three months later when you make your return visit.
If you have a relatively high CD4 count, no symptoms and you are not taking antiretroviral drugs, your CDXUMUMX count will be monitored every three to four months, or even every six months if it is very high.
However, if your CD4 count is falling fast or nearing the recommended start of treatment level (currently in 350 for most people) or if you are participating in some clinical trial, your doctor may suggest smart of you to accept, that your CD4 count is monitored more frequently.
After you start your antiretroviral drug treatment, you will often have a new CD4 count about one month after you start treatment, and every three months. Once you have your viral load undetectable (see viral) and your CD4 count begins to rise, your doctor may suggest that you count it every three months, and then every six months. You may have, in the focus of your expectations, that there will be a higher frequency of testing if your count stops rising if you show symptoms or do not feel well.
Tracking your CD4 count will help you and your doctor make important decisions about your overall health and HIV treatment, do not give up on that
CD4 count above 350 - monitoring and initiation of treatment in some circumstances.
If your CD4 cell count is above 350 and you are symptom-free, you probably will not need to start your treatment now. But your CD4 count will be maintained on a regular basis every six months. As your cd4 count begins to approximate 350, you may want to monitor it more closely, every three months for example, or even shorter intervals.
In some situations your doctor may determine that you start antiretroviral treatment even if your count is above 350. These possibilities include:
- IF you are coinfected with hepatitis B or C viruses, liver disease worsens if the CD4 count is low.
- If you have kidney problems.
- If you are in treatment for cancer.
- If you are relatively advanced age (above 50, for example).
- If you wish to start treatment because you are concerned about the possibility of transmitting HIV to someone (the treatment greatly reduces the possibility of transmitting the virus).
- If you are sick because of HIV infection.
- In some cases, if it is clear that you have recently acquired HIV.
CD4 Count on 350 - Starting HIV Treatment
If your CD4 count drops to 350 or near 350, it is usually common to start HIV treatment. It has been shown that starting treatment with the CD4 count around 450 brings a number of advantages than if started with CD4 at lower counts.
The immune system recovers more easily and quickly when treatment begins with the CD4 count around 350.
Starting your treatment with the CD4 count around 350 creates a condition where you will hardly get sick because of HIV. It has also been shown that starting HIV treatment at this count greatly reduces the likelihood of you developing serious diseases such as kidney or liver disease as well as some cancers.
Your doctor will talk to you about starting treatment when the CD4 count approaches 350. At this stage of treatment you will have more frequent CD4 exams.
CD4 count at 200 or below - immediately start treatment for HIV and prophylaxis for other diseases
If your CDXUMUMX count is at or below 4, it is imperative that your doctor initiate HIV treatment immediately. A CD200 count at 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 medicines, such as antibiotics, to prevent the onset of these diseases; This is called chemoprophylaxis. The type of chemoprophylaxis you will start will depend on your CD4 count. Only your doctor, not you, is able to tell you when you can safely stop doing chemoprophylaxis. This generally occurs when the CD4 count rises above 200 and remains, some time, above this.
For example, you may be given antibiotics (such as Bactrin or Dapsone) to prevent PCP, a dangerous type of pneumonia.
You may have to take other tests to evaluate your medical / clinical condition. This may include tests to evaluate diseases and conditions, and may include tests for tuberculosis (TB). In countries like Brazil, with high rates of tuberculosis, you will be tested anyway
Your CD4 count when you are being treated for HIV
As soon as you begin treatment for HIV your viral load will begin to fall and the CD4 count is expected to rise, gradually. The rate of this growth varies from individual to individual and depends on several factors. In some people it takes months and sometimes years for the cd4 cell count to rise to normal levels for the person's age. In general terms, the lower the viral load when you start treatment, the longer the immune system will recover completely. But it is good that you understand that even the slightest change in your CD4 score, upwards, brings immense benefits to your health
Your doctor will monitor your viral load and your CD4 count every three months until this normalizes. Once your viral load becomes undetectable and your CD4 cell count begins to rise, your doctor may suggest (and it is up to you whether or not to accept) that the monitoring of these pathways goes on for longer periods, such as each six months..
Percentage of CD4
In addition to counting and monitoring the CD4 count, some physicians sometimes measure the proportion of how many white cells are CD4. (There are macrophages, TK cells, CD8 and others, all with defined functions that are important to your health.) It is called the percentage of CD4 cells. Although this White Cell Measurement System is not best suited to monitor the health of the adult immune system, there are situations where this measurement is useful.
For example. If your CD4 count is very different from the percentage of CD4 it may be the indicator of another health problem
Another situation where this comparison is useful is when there is a very large variation between the CD4 count and the percentage of CD4, because there may be some kind of lack of tuning in these paths and this may be a warning sign that bigger problems may be about to occur, and so the doctor may ask for extra medical tests, as the people say, to cut off evil at the root.
It is very important that the cd4 cell counts
The Original you find here.
The CD4 cell count is critical in the treatment of the person living with HIV and the person living with AIDS