Question
Why does my CD4 count go up and down?
27 June 2016. Related: All topics, CD4 and viral load, Life expectancy, Starting treatment.
I’ve been HIV positive for 4 Years. I am not on HIV medicine. My 1st CD4 count was 545, since then it’s been up to 1225 and down to 725. My last CD4 was 1083. And my viral load is 1000. What is the reason my CD4 count goes up and down? What is my life expectancy?
Answer
Everyone’s CD4 count goes up and down. For example CD4 counts are lower when you wake up, and higher later in the day. They are higher just after exercise, and they are affected by diet or having other infections too.
None of these changes mean that your immune system is stronger or weaker. A CD4 count between 500 and 1200 is strong. For someone who is not on treatment, a viral load of 1000 is also very low.
However, here in the UK HIV treatment guidelines recommend starting HIV treatment (ART) at any CD4 count. This is because ART can help to keep your health strong whatever your CD4 count is.
Now in 2016, HIV medicines are safe and effective, so many people on ART now can have a normal life expectancy.
You can find out more about ART and starting treatment here.
Best wishes,
Roy
Hello Garry and thanks for getting in touch.
Yes, the CD4 count in all people goes up and down.
This is normal.
The important aspects here are:
1. you remain undetectable. This means the medication is working very well for you.
Well done for that. I am sure it shows your great dedication to following your treatment.
2. you have made huge steps in your recovery.
That’s amazing!
I am very happy to hear the important improvement you have had.
Continue with your medication as your doctor advised and everything will normalise again.
As you have realised it takes time but you are certainly moving in the right direction.
My CD 4 count was 3 at diagnosis. I had Pneumonia Tuberculosis and then contracted Covid whilst in hospital. I had to wait to start my recovery on Dovato. Two years have passed: my viral load is undetectable and my CD rose to 249. Now my CD count has dropped to 205 whilst my viral load is still undetectable. Is this normal for a CD 4 count to drop ?
Hi Tobias, as your viral load remains undetectable it means your treatment is still working. When was your CD4 count last in a healthy range (430-1630)? Have your results been reviewed by a doctor? As HIV is being suppressed by your treatment, it is possible that there is another reason for this drop in CD4 count. Do you also have a CD4 percentage? This is usually a better measure for the healthy of your CD4 count.
Hi,
I am on medication for my HIV since over 5 years. My recent tests in the last 9 months have all showed a very low CD4 count of around 250 going down to now 214. My viral load remains undetectable. Under 50 copies.
I am worried because obviously CD4 counts of under 200 generally mean you have AIDS.
Should I be worried? What actions can I take to get my CD4 up. FYI my CD4 counts have never been amazing. I think my highest was nearly 800.
Any advice would be greatly appreciated.
T