Q and A

Question

Can my CD4 and viral load show when I became HIV positive?

Hi, I just got my results yesterday after i visited the doctor for something else and he suggested to run all the tests including HIV. My CD4 is 156 and my viral load is 913,000 and i am starting the treatment. I last tested in 2018 and i was negative. What is causing my CD4 to drop so quickly?

When do you think i got infected? I just met someone and started dating and i remember very well we started having sex without protection in March. Could it be i got it from him or from my ex bf that i broke up with last year. I told my boyfriend about the results and he is going to test on Tuesday.

Answer

Hi there

Thanks for your question – and for letting us answer this online.

How are you managing with finding out you are positive. Even though most people find this difficult, it does get much easier over time.

These tests by themselves can’t tell you when you became HIV positive. You can however make a rough guess based on your previous negative results and your history of risk.

A low CD4 count and high viral load are usually seen in either (i) people who have been HIV positive for 5-10 years (ie advanced infection) or (ii) in someone who was recently diagnosed (within the last few month).

Because you were HIV negative in 2018 and had a more recent risk, it is likely that this is a recent infection. It is good that your ex is testing and the results might help narrow the window.

Either way, it is good that you are starting treatment as this will increase your CD4 count and viral load. The CD4 count should already be increasing even before you start meds. This is because the CD4 count drops in the first months of infection and then goes higher again anyway.

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