Q and A

Question

When was I infected?

I tested for HIV this month and my CD4 count is 293. Does that mean I had this disease for a long time and did not even know about it?

Answer

I am very sorry to hear about your recent diagnosis. Finding out you have HIV is never easy and it can be a lot to cope with. Do you have any support to deal with this?

A CD4 count of 293 is not very low, although it is low enough that your doctor is likely to suggest you start treatment soon. This is because there is a higher risk of getting ill when your CD4 count is under 350. This doesn’t mean you definitely will get sick, just that it is more likely the longer you are off treatment.

It’s hard to tell whether this CD4 count means you have been living for HIV for a long time. This is because everybody’s natural CD4 level is different. The ‘normal’ CD4 count for somebody without HIV can be between 400-1600. If your normal CD4 was 400 it would probably take less time for it to drop to 263 than if your normal CD4 was 1600. Unfortunately we don’t know our CD4 counts unless we are diagnosed with HIV.

HIV also affects people differently. Some people’s CD4 counts drop very slowly, and others more quickly. This is another reason it’s difficult to know when you were infected from one CD4 count.

A third reason why this is difficult is that when somebody is newly infected their CD4 count can drop very low, and then it can go back up a bit as their body fights back against HIV. Please follow this link for more information about CD4 counts after infection.
Has your doctor or nurse spoken to you about starting treatment? Because your CD4 count is under 350 it is recommended that you start treatment soon. This doesn’t have to be immediately though, and it’s important to understand HIV treatment before you start. We have a guide online which talks you through lots of the questions about starting treatment. You can read it here: Introduction to combination therapy.

Finally if you would like to contact an HIV positive organisation in South Africa you might be interested in TAC. Their contact details are on their website.

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