Late diagnosis and low CD4s

In the UK – and many other countries – about 40% of all new diagnoses are made when the CD4 count is already less than 350.

About 1 in 5 (20%) are diagnosed even later, with a CD4 count below 200.

Reasons for not taking an HIV test earlier include:

• Not thinking you are not in a high risk group.
• Other fears about testing.
• Denial and thinking somehow you are protected: “it will never happen to me”.
• Fear of stigma and prejudice if the result is positive.
• Lack of up-to-date information about HIV and treatment.

Being diagnosed late often means starting treatment on the same day that you first see an HIV doctor.

If you have serious symptoms and are admitted to hospital, you might need other infections treated first. ART will be started shortly afterwards.

Even with a very low CD4 count – even below 50 – if you take your drugs carefully, you have a good chance that ART will work. Your viral load will drop and your CD4 count will rise to safer levels.

However, starting with a very low CD4 count can cause some infections to activate, such as TB. This is called Immune Reconstitution Inflammatory Syndrome (IRIS) and is serious, but usually easy to treat.

Last updated: 1 November 2024.