Phase 3; Immune system restoration (CD4 level recovery)
A CD4 count is a good indicator of immune system strength. Overtime Immune Plus rebalances and strengthens the body so that the immune system can recover to function normally and replenish CD4 cells. Once a significant VL reduction has been achieved then this effect is enhanced and the CD4 count should begin returning to normal levels. One may consider that CD4 level tends to be lower in the morning and higher in the evening. In addition acute illness such as pneumonia, influenza and herpes simplex can cause the CD4 count to decline temporarily. Other induced influences such as chemotherapy can dramatically lower the CD4 count as can stress, smoking and excessive alcohol. When taking a CD4 test one should maintain awareness of influences upon the immune system that not part of the HIV infection.
The following CD4 levels in relation to the severity of immunosuppression are offered by the World Health Organisation (WHO) and may serve as a guide for progress:
> 500/mm3 - no significant immunosuppression
350-499/mm3 - mild immunosuppression
200-349/mm3 - advanced immunosuppression
<200/mm3 - severe immunosuppression
Group characterisaztion:
The World Health Organisation (WHO) has developed a staging system for HIV in adults and adolescents based on clinical symptoms. For each stage guidelines have been added to help 'Immune Plus' users conceptualise potential progress. Please consider that this is a guide based upon our experience but is in no way a guarantee and it may significantly vary between individuals.
Clinical Stage I:
Asymptomatic
- Persistent generalized lymphadenopathy
Immune Plus expectation guide against a timeline:
May prevent progression to clinical stage II from 3 months onwards
Clinical Stage II:
Moderate unexplained weight loss (under 10% of presumed or measured body weight)
- Recurrent respiratory tract infections (sinusitis, tonsillitis, otitis media, pharyngitis)
- Herpes zoster
- Angular chelitis
- Recurrent oral ulceration
- Papular pruritic eruptions
- Seborrhoeic dermatitis
- Fungal nail infections
Immune Plus expectation guide against a timeline:
Phase 1 : improvement anticipated within 6 months
Phase 2 : improvement anticipated from 6 months onwards
Phase 3 : improvement anticipated from 9 months onwards
(note that phases are defined above under 'gauging progress')
Clinical Stage III:
Unexplained severe weight loss (over 10% of presumed or measured body weight)
- Unexplained chronic diarrhoea for longer than one month
- Unexplained persistent fever (intermittent or constant for longer than one month)
- Persistent oral candidiasis
- Oral hairy leukoplakia
- Pulmonary tuberculosis
- Severe bacterial infections (e.g. pneumonia, empyema, pyomyositis, bone or joint infection, meningitis, bacteraemia)
- Acute necrotizing ulcerative stomatitis, gingivitis or periodontitis
- Unexplained anaemia (below 8 g/dl), neutropenia (below 0.5 billion/l) and/or chronic thrombocytopenia (below 50 billion/l)
Immune Plus expectation guide against a timeline:
Phase 1 : improvement anticipated within 9 months
Phase 2 : improvement anticipated from 9 onwards
Phase 3 : improvement anticipated from 12 months and onwards
(note that phases are defined above under 'gauging progress')
Clinical Stage IV:HIV wasting syndrome
Pneumocystis pneumonia
Recurrent severe bacterial pneumonia
Chronic herpes simplex infection (orolabial, genital or anorectal of more than one month's duration or visceral at any site)
Oesophageal candidiasis (or candidiasis of trachea, bronchi or lungs)
Extrapulmonary tuberculosis
Kaposi sarcoma
Cytomegalovirus infection (retinitis or infection of other organs)
Central nervous system toxoplasmosis
HIV encephalopathy
Extrapulmonary cryptococcosis including meningitis
Disseminated non-tuberculous mycobacteria infection
Progressive multifocal leukoencephalopathy
Chronic cryptosporidiosis
Chronic isosporiasis
Disseminated mycosis (extrapulmonary histoplasmosis, coccidiomycosis)
Recurrent septicaemia (including non-typhoidal Salmonella)
Lymphoma (cerebral or B cell non-Hodgkin)
Invasive cervical carcinoma
Atypical disseminated leishmaniasis
Symptomatic HIV-associated nephropathy or HIV-associated cardiomyopathy Immune Plus expectation guide against a timeline:
Phase 1 : improvement anticipated within 12 months
Phase 2 : improvement anticipated from 12 months and progressively onwards
Phase 3 : improvement anticipated from 18 months and progressively onwards
(note that phases are defined above under 'gauging progress')
Note; If one has sustained permanent internal damage, such as to the kidney or liver or succumbed to chronic illness such as cancer then one should not expect Immune Plus to support recovery from such.