Question
Why does my CD4 count go up and down?
27 June 2016. Related: All topics, CD4 and viral load, Life expectancy, Starting treatment.
I’ve been HIV positive for 4 Years. I am not on HIV medicine. My 1st CD4 count was 545, since then it’s been up to 1225 and down to 725. My last CD4 was 1083. And my viral load is 1000. What is the reason my CD4 count goes up and down? What is my life expectancy?
Answer
Everyone’s CD4 count goes up and down. For example CD4 counts are lower when you wake up, and higher later in the day. They are higher just after exercise, and they are affected by diet or having other infections too.
None of these changes mean that your immune system is stronger or weaker. A CD4 count between 500 and 1200 is strong. For someone who is not on treatment, a viral load of 1000 is also very low.
However, here in the UK HIV treatment guidelines recommend starting HIV treatment (ART) at any CD4 count. This is because ART can help to keep your health strong whatever your CD4 count is.
Now in 2016, HIV medicines are safe and effective, so many people on ART now can have a normal life expectancy.
You can find out more about ART and starting treatment here.
Best wishes,
Roy
Hi Frank,
There’s been a slight rise in your girlfriends viral load, is she taking her medication daily as prescribed?
If her viral load is less than 200 copies ml, there’s no risk of transmission. If it goes above this, then there’s a risk.
Due to the slight rise, it’s important that her viral load is monitored, it could be a lab error, it could however be a sign that there’s an issue with her treatment.
hi prof.
my gf start HIV treatment from year and half ago her VL was 38 and log 1.6 in last Aug2020 and less than 50 in Sep 2020 new test in 20 Jan 2021 was
151 with log 3.2 and CD4 was 425 39% from range (32%- 64%) mean she still ok and still undetectable and can make love safely thanks a lot
Hi Prospero,
When you say IS are you actually referring to your CD4 count? If you are then it’s common for CD4’s to fluctuate. As long as your viral load is undetectable, so less than 50 copies ml, this means that your HIV is under control. Having temperature won’t affect your viral load. 37 is a normal body temperature, so isn’t classed as being high.
Hello,
I’ve had HIV for 8 years, I’ve been on therapy for 5 (efavirenz, tenofovir, lamivudine). Throughout the 5 years, my VL was undetectable and my IS was high (700-800, around 37%). In September 2019, a low VL was revealed (my doctor told me this could happen), in January 2020 the VL was back to undetectable and the IS was 670. Yet, in May 2020, my IS was revealed to be down to 500/29% (confirmed by two tests: 480 and 540 resp), and it is currently impossible to measure the VL because the lab in my hometown is overloaded with covid. I have my next appointment in July and I am really worried about what’s going on. In May, the doctor said the drop may be due to stress or illness, but I’ve been screened by my GP since then and I seem to be in order (although since April my temperature has consistently been at 37 which is untypical, my neutrophils are low (39%) and my lymphocytes are high (50%). Could the temperature rise mean a rise in the VL? And can HIV possibly cause a deterioration in CD4% even when the VL is suppressed? Thank you!
Hi Fire,
The short answer is that you shouldn’t be concerned.
CD4 counts can go up and down. And they can be higher or lower at different times of the day too. Your viral load is undetectable on HIV treatment. And this means that a CD4 count above 500 is considered normal. So this can be the reason why you don’t get sick.
You hardly miss your meds for 3 years now. And so it sounds like you’re doing great. You can always talk to your doctor if you are concerned, just to check that all is well.
Hi.
i’m concerned about my CD4 count. In August 2019 it was 808, in January 2020 it was 734 and the latest one May 2020 it is 616, is this normal and should i be concerned? My VL is undetectable for 3 years now. And i hardly miss my meds.
i hardly get sick. what could be the course? what tests can i do to find the problem?
thanks..
Hi Josias, if your combination includes efavirenz, please read the information at this link which has some suggestions.
https://i-base.info/qa/12092
Hi my problem is, alway i feeli dizzy after taking my treatment from five years back,what can i do?pls help me or i have to leave my treatment?
No. If you were HIV negative before they were born, you didn;t have the virus for this to be a risk.
I am a mother of 2 but they were born b4 i was infected is the any possibilities fr them to be infected?