Question
Why is my viral load high and CD4 so low?
6 January 2021. Related: All topics, CD4 and viral load.
I’m newly diagnosed (October 2020 – Male/39/Black) and had a viral load of just under 4 million and CD4 count 7.
I have started ART (November 2020) how long will it take for; viral load to undetectable and CD4 count to be over 200?
Also I’m very confused about when I could have been infected as the very low CD4 count would indicate 5-10yrs but the very high viral load would indicate 3-12 months, is there a way to tell?
Answer
Thanks for getting in touch.
How are you doing with your diagnosis? Are you getting any support?
If your viral load is this high, it’s very likely that this could be a new infection. However this all depends on whether you’ve had any risks. Have you had a risk in the last few months?
In primary infection, viral loads are high and CD4 counts can drop and drop to very low levels. A CD4 of 7, is however very low. Therefore, it’s possible that this isn’t a new infection. To have an idea of when you were infected, you’re going to need to think about any risks you’ve had. Also, when did you last have a HIV test?
Though you’re keen to know how long you’ve had HIV for, the important thing is that you’re now aware of your status.
As you’ve started medication your viral load will be decreasing. A persons viral load should become undetectable within 1-3 months of starting ARVs.
With regards to your CD4 count, it’s not possible to say how quickly this will rise. It will rise, though at a much slower rate than your viral load will decrease.
Given that your CD4 is very low, please see here: https://i-base.info/qa/4643
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