Question
What does my CD4 percentage mean?
7 January 2017. Related: All topics, CD4 and viral load.
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.
Hi, Testing positive can be a worrying time for many people.
But most people benefit by starting HIV treatment (ART) whatever their CD4 count is. And a CD4 count of 580 is strong. So delaying starting by a couple of months is unlikely to affect your health.
However, you can use this time to think more about starting treatment. You can ask the clinic about ART, what might be best for you, and how you will need to take it.
You can ask the clinic to start ART whenever you feel ready, and that includes right now.
Hi, I did an HIV test today and I am positive with a CD4 count of 580. They said I should come back after 3 months before I start treatment, should I wait till then or start treatment right now?
when your CD4 count is 397 you have to do some thing fast because there are so many things that can drop your CD4 wether HIV+ or HIV- , think of stress, diety, reinfection,nutrition and so many things, what you should do is to work on these condition by seen healthy proffessionals who cal guide you
Thanks – although nearly everyone can benefit from being on ART, a CD4 count og almost 400 is still pretty strong. If it is helpful to take a little more time to think about starting treatment, a few weeks or even months is unlikely to affect your health. Having said this, most people find ART much esier than they expected and often wonder why they didn’t start earlier.
Hi Ron
There is a lot of fluctuation in CD4 counts and the CD4%. In general you have made a great response to treatment and this does;t sound like anything to worry about.
Please speak to your doctor if you are worried – but his or she is likely to give similar information.
Hi,
I am HIV positive and am currently on treatment as well. My. CD4 count had been increasing consistently from 198 (12%) to 350 (20.3%) this past one year. However, the recent result showed that the CD4 absolute count was down to 258. However, the CD4% was up from 20.3% (three months ago) to 27.4% (current) which is a consistent increase since the treatment started.
Do i need to be concerned about this number or could it be an anomaly?
Hi Ben
Your CD4 count is the main marker and this shows you have a very good immune system. There is a wide range for these test results. Your doctor is not likely to be something that your doctor is worried about.
If you are not yet on treatment, your doctor might use a lower CD4% as a reason to consider earlier treatment in the future, but only if it steadily drops much lower.
This may also depend on which country you live in as guidelines can be different. Some countries, including the UK, include the option to start treatment earlier. This is mainly when there are either other medical reasons or someone want to be less infectious to their partner.
This link may also be helpful:
https://i-base.info/qa/20
I am 24 years old and I am HIV positive. My CD4 count is 623 but my CD4% is 19% which is lower than normal. Should i be worried. What to do next?
Hi Tapiwa,
In the UK you would be recommended to start treatment because your CD4 count is under 350. Have you started treatment yet?
i’m hiv postive my cd4 counter is 293 what can i do