Q and A


How long will I live if I start ARVs on a CD4 count of 500?

I tested hiv positive after three month of sex exposure with sex worker. My viral load and cd4 counts results yet to come, and here in nepal HAART service is not available. What is my life expectancy if I start ART treatment when my cd4 count just below 500.


Thanks for getting in touch.

How are you coping with your diagnoses? Are you able to get any support? Do you know when you’ll get your CD4 and Viral load results?

ART if taken as prescribed is a very effective treatment. And this includes when started on a very low CD4 count. Which 500 is not.

So long as you start treatment before your CD4 count drops below 350 your life expectancy is very good, similar to somebody who is not HIV positive.

There are lots of previous questions about life expectancy here.


  1. Roy Trevelion

    Hi Ricardo,

    Thanks. Please let us know what the doctor says.

  2. Ricardo

    Hi Roy (sorry for double posting as I didn’t see the response)

    I am on Genvoya and luckily not too many side effects apart from some muscle pain. I am due to see the doctor in three days.

  3. Roy Trevelion

    Hi Oreo,

    It’s quite difficult to say how long someone will live. That’s because there can be other factors that change our life expectancy.

    But HIV positive people start treatment at any CD4 count now – and that can benefit health. Please see the START study.

    Unfortunately it’s not possible to say if your life expectancy would be worse starting treatment with a CD4 count of 350.

  4. Oreo

    Hi I started my treatment when CD4 count was 334.

    You said “So long as you start treatment before your CD4 count drops below 350 your life expectancy is very good, similar to somebody who is not HIV positive.”

    Does that mean my life expectancy would be worse as I started treatment below CD4 count of 350?

  5. Lisa Thorley

    Hi Mike,

    What’s your CD4 count history from diagnosis to now?

  6. Mike

    Recent change in insurance required a change in doctors. The new one thinks I’m likely at my recovery plateau. At under 300 for a cd4 count this isn’t good news. All the studies write of those over 350 or under 200. What should I expect falling irritatingly in the middle at 265-280? The percentage hasn’t budged off of 14% since diagnosis just over a year ago.

  7. Roy Trevelion

    Hi Thobius,

    Your CD4 count tells you how strong your immune system is. A CD4 count of 550 is within the normal range for someone who is HIV negative.

    Your viral load result tells you whether you are more or less likely to transmit HIV when having sex without a condom. If you have a viral load under 50 copies/mL the result is called undetectable.

    If you stay undetectable on HIV treatment (called ART) you cannot transmit HIV even if you don’t use condoms.

    Here’s more info about undetectable = untransmittable (U=U).

  8. Thobius

    Does the people who have CD4 Counts 550can be able to transmit HIV/AIDS

  9. Roy Trevelion

    Hi Ricardo,

    Starting ART before your CD4 count get to 350 is a recommendation from older guidelines.

    ART is now recommended starting at any CD4 count. However, many people have started ART when their CD4 count was lower than 334.

    There are many things that can affect life expectancy. So starting at 334 rather than above 350 might not make a difference.

    What meds are you taking?

  10. Ricardo

    Hi you mentioned starting ART before CD4 count is above 350. I started mine by 334, does that mean my life expectancy would be affected?


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