Q and A

Question

What does my CD4 percentage mean?

Answer

Most information about how HIV affects your health comes from your CD4 count. This includes how HIV has damaged your immune system and how HIV treatment (ART) is making your immune system stronger.

The CD4 count is usually given as a number (usually between 1 to about 1600 cells/mm3).

This number is called the ‘absolute’ CD4 count.

However, many things affect this absolute number. These includes the time of the day, what you have eaten, if you have taken exercise, or if you have other infections. Each of these factors can affect your CD4 count but they are not related to immune system.

If your CD4 results are ever much higher or much lower than you expect, your doctor should look at your CD4 percentage (CD4%).

The CD4% can indicate whether this is a real change, or just a fluctuation. The CD4% is generally more stable.

The absolute CD4 count is still best at predicting risk of HIV progression.

The CD4% is the percentage of white blood cells that are CD4 cells. In an HIV negative adult the average CD4% is about 45%.(But this can range from 24% – 64%)

In adults, a CD4 percentage of 12-15% is considered similar to a CD4 count of 200 cells/mm3. A percentage of 15-20% is similar to an absolute count of 300 cells/mm3.

Babies and children with HIV are monitored using CD4%, because their absolute CD4 counts are much higher than adult counts, especially in the first few years.

CD4% may be an independent predictor of HIV disease progression, and a low CD4% should be considered as a factor in starting treatment, even when the absolute CD4 count is relatively ok.

This answer was updated in January 2017 from a question first posted on 8 October 2012.

101 comments

  1. Sherif

    Hello , my HIV result came positive only two weeks ago I started Ranega first viral load test is 29400 , I did my CD 4 test twice same day one resulted in 273 cells with 14% and the other rented in 109 cells with 8.7% . How is that possible ??!! My second question is last test that I had was two years ago unfortunately and it came negative so that means I got infected within the past two years only so how come my T cells went down that fast while my viral load is only 29400 .

    I started Ranega immediately and am waiting for its result in a month

  2. Simon Collins

    Hi Candy, please don’t worry about this. Your CD4 count is so good that the percentage doesn’t matter. The estimates for the percentage are not that precise.

  3. Candy

    My cd4 count is 851, cd4% is 16.
    How is that possible?.
    I thought that my % would also be high?

  4. Josh Peasegood

    Hi Paul, were you given a unit with this .90 CD4 count?

    CD4 count is usually given as a whole number.

    0.9 can be the result of the CD4/CD8 ratio which would be a healthy result.

    Were any of these results explained to you when they were given back to you?

  5. Paul

    Is a .90 cd4 count 900

  6. Josh Peasegood

    Hi Anil, have you done a test for HIV and are you on treatment?

    A CD4 count of 16 is very low. This means that HIV (if you are positive) has damaged your immune system and you are now vulnerable to other diseases/infections. HIV treatment can help let your Cd4 count recover.

    Do you know your viral load?

    HIV treatment works by suppressing HIV and stopping it from killing CD4 cells. Your body can then naturally regenerate its own CD4 cells and recover your immune system over time. Have you also been started on a treatment called co-trimoxazole? This is an antibiotic used to prevent other infections while your body recovers.

    This is a link about starting treatment: https://i-base.info/guides/starting

  7. Anil

    Cd count4 is 16
    Plz tell me what is condition now
    How is increasing cd 4 count

  8. Josh Peasegood

    Hi Mickey, this is excellent. Being undetectable with a CD4 count in a healthy range is great. It shows that your treatment is working – HIV is being suppressed and not damaging your immune system.

  9. Mickey

    Hi, after 4 months of therapy, I reaced undetectible PCR and CD4 480. CD4 was 250 when I started therapy.
    Is this ok?

  10. Josh Peasegood

    Hi Mickey, being undetectable means that the virus cannot destroy other cells. Your body is safe and HIV will not cause any further damage. HIV is clever and can hide in areas that treatment is unable to access. This is why it cannot be completely removed from the body. The virus can remain sleeping (dormant) in cells which means that is it not actively replicating. Because the virus is sleeping, treatment will not target the cell but it also means HIV will not kill the cell.

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