Q and A

Question

I am just diagnosed with a CD4 count of 10?

I’ve recently tested HIV+ and unfortunately my CD4 count came out at 10. I am not ill, but do i have the chance to live any longer.

Answer

Hi

As well as being HIV positive, your CD4 count is very low. Unless you were only infected very recently, this means your HIV is very advanced.

Using ARV treatment (ART) as soon as possible is important. ART will reduce the serious risk of HIV-related health complications.

The medicines will still work for you. There are many reasons to be hopeful and optimistic.

Because your CD4 count is uder 50 there is also a chance that other infections (called IRIS) might become active during the first few months of treatment. These are usuallly easy to treat, but tell your doctor about any new symptoms over the next months.

Also, please be very careful not to miss any doses of your meds. This is called good adherence.

Your doctor should also give you antibiotics to protect you from other infections. This is usually cotrimoxazole (often also called Septrin or Bactrim) which is a combination of  trimethoprim and sulfamethoxazole. This treatment should continue until your CD4 count gets much higher (at least above 200, maybe above 350).

While your CD4 count is still below 50, including now, your doctor should also examine your eyes. This is to check whether a viral infection called CMV is affecting your eyes. CMV can cause serious and permanent vision loss.

For more information see this guide to starting treatment, called Introduction to ART.

If you were not expecting to be HIV positive, this will take a while for the news to sink in. It will get easier – and hopefully you will get a good response from treatment.

These two links might help:

Just diagnosed:
https://i-base.info/just-found-out

Who can I talk to:
https://i-base.info/who-can-i-talk-to

Note: This answer was updated in December 2016 from a question first posted on 13 September 2011.

139 comments

  1. Simon Collins

    Hi Lirato, thanks, mordern HIV meds work very quickly and your viral load will already be much lower. Withgout details of your CD4, viral load, meds, and starting dates it is difficult to comment in detail.

    It is really good that you were diagnosed though and started meds as you are doing all the right things for both your health and your baby.

    Your health team will be really experienced at doing everything to look after you both and it is good to ask them about anythin that you want to know.

  2. Lirato

    I am 37 weeks pregnant and I’ve tested positive without any symptoms of having an hiv so started the meds right away so now my concern is that will the baby be affected too or what coz am about to deliver soon and my cd4 count is low and my viral load is high

  3. Josh Peasegood

    Hi Meriam, you can restart your treatment now. There is nothing you need to do before restarting.

    Do you know what your viral load was before stopping? If you were undetectable, it can take a week or more for the viral load to rebound. This means it is likely that you would have remained undetectable for the time you were not taking treatment.

    But because there is a very small risk of a rebound/treatment not working, it is recommended to sort a viral load test in the next few weeks. This is to check that your treatment will still be working.

    Do you mind me asking why you missed your ARVs for a week? Do you think this will happen again in the future?

  4. Meriam

    I stop my Arv medication for a week how. do start again

  5. Josh Peasegood

    Hi Zach, log values are used as a measure for viral load and not CD4 count. Is it possible these results were mixed up? As you have been undetectable with a CD4 count around 500, it would make more sense that your viral load is log 1.60 and CD4 count is 555.

  6. Zach

    Hi I have been on ARV since 2017 and since then, I had a good viral load (undetectable) and CD4 (between 400-500). However, I just got a result of my recent CD4 and viral load, they are:
    – CD4: <4.0 X 10^1 (log 1.60)
    – Viral Load; 555

    Its very concerning to me and I have booked an appointment with a doctor. but how come my CD4 dropped drastically, doesnt make sense to me

  7. Josh Peasegood

    Hi Norma, it is good that your CD4 count has risen and that your viral load is now undetectable. Unlike viral load which changes rapidly after treatment, CD4 count recovery is a slow process and takes time.

    It is slower when starting from a lower count. As your CD4 count was 116 it will recover slower than someone who starts at 300. A rise of 30 over a year may be seen as slow but it is good process and it should increase faster over time.

    While your CD4 count is low are you also on an antibiotic called co-trimoxazle? This is used to prevent further infections as your CD4 count recovers.

  8. Norma

    Sir/ madam

    My initial cd4 count was 116 and after a year of taking arvs it has risen to 149. I am.concerned, why has it risen so little? I am now undetectable

  9. Lisa Thorley

    Hi Lala,

    i-base advocates aren’t medical doctors so I can’t comment on the spots that I have. You’ll need to talk to a doctor about this. Once you start medication your viral load will decrease and your CD4 count will rise. Please see here for more info: http://i-base.info/guides/side

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