CD4 Once More

As someone currently living with HIV, it’s standard that I get my cd4 count measured every six months. I last had it done in February, when I went with O, and so August signaled it was time again to get my cd4 count.

Was I excited? Hardly.

Anxious? Definitely.

A cd4 count is a measure of cd4+ t-cells in my blood, which tells me how my immune system is doing. Because the lifecycle of the HIV virus involves it using these t-cells to multiply, killing them off eventually, the higher the cd4 count the better.

A normal person – someone without HIV – should have a cd4 count of 500 to over a thousand. The critical point for someone with HIV is a cd4 count of below 200, meaning his or her immune system has deteriorated significantly. This is the point at which he or she is said to categorically have AIDS. It is also at this point that a person is expected to be extremely susceptible to opportunistic infections, like tuberculosis, pneumonia, meningitis and others.

Cd4 counts still aren’t sure signs though of the condition your body should be in. I’ve met some people who have cd4 counts in mere double-digits already, but who are still in good physical states externally. I guess it’s pretty consistent with HIV itself, in that you can’t tell unless you get tested.

Not to fret though. A cd4 count of below 200 doesn’t mean it’s the end of the world. There are ways which allow the cd4 count to recover, and among them are ARVs or anti-retrovirals. ARVs are medicines usually given in cocktails or combinations which are able to interfere with the process of multiplication of the HIV virus, keeping it at bay, and allowing the immune system some leverage to recuperate.

I think the best case I’ve seen is a friend of mine in the US who reached the point of a cd4 count of zero – yes, absolute zero – but is now enjoying a 300+ cd4 count and living a normal, healthy and productive life. The only catch, I think, is that once you reach the AIDS-level of a cd4 count below 200, you categorically will never be removed from that classification, even if your cd4 count recovers to above 200. For me, HIV is HIV, no matter what the cd4 count. And AIDS is just a name, something for statistical purposes.

So anyway, back to me. Back in June 2008, if I remember right, I got my first cd4 count when I was still with the San Lazaro Hospital. It was 343. By August, I was able to transfer to the RITM, where they took new baseline data. My cd4 had gone down to 328. Down 15 points in just 2 months. I attribute that to the stress and anxiety brought about by the ultimatum presented to me at San Lazaro that I needed to tell someone in the family, before they started me on ARVs. Something I just wasn’t prepared to do. At that point, with the guidance of the doctor at the RITM, I decided I’d start on ARVs.

After six months on ARVs, I got another cd4 count in February of this year. My cd4 went up to 484 at that time. A 156 point increase, and I was amazed. It was unexpected, and I was ecstatic. Again, I didn’t know what things I was doing right, to which I could attribute the increase, but hell, whatever it was, I’d take it. I was convinced that the ARVs were indeed working for me.

And this past week, I was due again for another cd4 count. Would it be a reiteration of the powers of ARVs? Or would it be a wake up call that it’s not always going to be all good?

I actually brought a couple of guys along last Tuesday who were just about to start their own HIV journeys. Just preparing myself and them for the trip kept me busy, so it wasn’t really until I was on the MRT on the way to our meeting place that I was again reminded that I was going to face a needle again. Sigh. It still scares me, and I still can’t watch it being done, but I’m much, much better at dealing with it. I think.

So we got to the RITM, and a needle, some blood, and a lot of hanging out later, we left... nope I didn’t get my results just yet. Ate told me it would be available the following afternoon. I was anxious, honestly. I just couldn’t confidently say which way it was going to go.

Wednesday, I got a text from Shola, excitedly asking for a pa-cheeseburger. My cd4 was 493. Up nine points. Hmm. I had mixed feelings. Nine points? Nine measly points? Compared to 156 in the six-month period prior to this one? Hmm. Not something instantly impressive.

But considering this six-month period involved some failed attempts at affection, fallouts with friends, leaving the comfort zone of my old job, delving into a new profession, wrestling with the longer daily commute, a grave ARV overdose mistake, and so many other possibly distressing situations... suddenly, nine points up doesn’t sound so bad. At least it didn’t go down, right? So there. I’m happy.