Q and A


Are the CD4 count fluctuations common?

I have recently found out that I am HIV positive. I also contracted Hep B. I have had my bloods done three times now. First time CD4 count was 500, second time 980. However, this third time it has droped back down to 560. I am not on meds yet. Also my viral load has increased from 60,000 to 80,000.

My question is do these fluctuations happen? My doctor told me not to worry. But it’s easier said than done. So I am interested to know if this is common. That CD4 count can go up and down and viral load is the same.


Yes, many people experience this.

The CD4 counts can be affected by many and varied reasons-i.e. stress, time of the day, menstrual cycle, other infections, recent vaccination, lab errors etc.

As your CD4 count is high throughout, you are not at any risk.

A more detailed answer to a similar question is published here.


  1. Simon Collins


    Your CD4 count is the most important test when deciding to start treatment. After three months treatment the CD4 count usually increases for 90% of people. For reasons that are not clear, about 10% of people don’t get such a good early response. It may be that you just need more time, but your doctor should be checking your treatment using a viral load test.

    Do you have access to viral load tests? If so, this will tell you how well your treatment is working. Once you are on treatment, viral load tests are more important than CD4 counts. I know that viral load tests are not available in every country.

    What does your doctor say about these results?

  2. Nosipho

    I started ARVs about 3 months ago and my cd4 count was 273 but now it has dropped to 241. should i be worried or i need to change my medication?


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