Question
My CD4 has dropped, but my viral load is undetectable, is this OK?
7 November 2017. Related: All topics, CD4 and viral load.
HI I was recently diagnosed HIV positive and discovered PCP lung infections as well. I started HIV medication immediately.
I made good progress and within six weeks VL came down to 160 – originally was detected around 3900. My CD4 improved from 96 to 206. My PCPalso got much better my cough gone. My concern is now after two month checks my VL is 23 BUT my CD4 count dropped to 115 from progressing piont.
I am contining with medication very carefully. Please guide me about the CD4 fall as I expected with low viral load to 23 that my CD4 level should rise more. My understanding is that the CD level actually help to make immune system stronger. Or its not any issues as long as my viral load goes to undetectable level.
Many thanks
Answer
Thanks for getting in touch.
CD4’s can and do fluctuate, as the following link discusses:
If your viral load was detectable then this may be something to worry about. However, as its undetectable it means that the meds are working, and working well.
Because you’re in the UK you could ask to have your CD4 count retested.
Also, your doctor will still need to prescribe antibiotics called cotrimoxazole until your CD4 count is stable at a higher level. This is for the PCP and other infections.
Hi John, how long has your brother been living with HIV?
Has your brother ever used HIV treatment? and what was his CD4 count when he was diagnosed?
It is great to hear how low his viral load is. Being on treatment will help to suppress this as much as possible. HIV treatment (ART) is the best and only way to help recover CD4 cells after being damaged from HIV. Treatment stops HIV destroying these cells and allows the body to naturally recover them.
While his immune system recovers he can also be on a medication called co-trimoxazole. This is an antibiotic used to prevent other infections that your borther may be at risk of.
More information about starting ART can be found here: https://i-base.info/guides/art-in-pictures
Hi my brother was tested positive for HIV .Ever since he had that he didn’t discontinue the ART treatment , But recently his CD4 is 88 but viral load is not detectable so what shall he do to increase the CD4 counts
Hi Emir, it is great that your brother is doing so well on treatment. His undetectable viral load shows that his treatment is working and HIV is not having any impact on his health.
A CD4 count between 500 and 600 is healthy. The normal range for a CD4 count is between 430 and 1690. Above 500 there is no additional benefit to having a higher CD4 count. The same immune response will be given if someone has a CD4 count of 500 or 1000.
For more information about CD4 count please see here: https://i-base.info/cd4-count/
Hi
My brother is 35, he has been using ARV for two years. When tests are positive his viral load is 1 milyon and CD4 is 560. After taking ARVs his vial load is undetectable for more than 13 months. But his CD4 is still between 500_600.
Is it possible to this patient’s to increase their CD4 or not?
Best regards
Hi Linda, what ARVs is she taking? and is the viral load and CD4 count result recent? If it is this is great, it means the medication is working and that her viral load has been suppressed – this will give time for the CD4 count to recover but this will be a slow process. As her CD4 count is this low has she been given any other medication? Usually called Bactrim/Co-trimoxazole?
Hi, my mom defaulted on her treatment for 3 years. She’s recently went back because she started getting sick. My concern is she is not getting any better 3 months into taking her Arvs. Her Cd4 count is 26 and her viral load is undetectable. She has pains, very weak can’t walk and no appetite. Can the cause be the meds? The doctor is not saying much. Thank you
Hi Yak,
Stigma can be an issue. However, when people think that you’re a threat its probably because they don’t understand that being positive isn’t the end of the world and that when someone is positive they can have a normal life. Ignorance is the issue here.
With regards to a cure, people all over the world are working towards finding a cure for HIV. However, at the moment this is some way off. For now we have ARVs. ARVs are very effective, and really do work.
Can they ever be cure for HIV? Because once you disclose your status to someone they tend to look at you as a threat.