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.
My absolute CD 4 Helper is Low at 29 and my % CD 4 Pos. Lymph is Low 4.2%. What does this mean? I have Multiple Sclerosis is this why it’s low?
Hi Zizi,
What ARVs are you taking and how long have you been taking them? Do you have access to your viral load result?
If viral load is undetectable it means your ARVs are working well. And this can give your CD4 count the chance to recover.
My CD4% is 10%, but CD4 is 252.
Do I have a risk of opportunistic diseases?
Hi Theinsoe,
Do you mean your CD4% is 27.2% ?
As it says above, the average CD4% in an HIV negative adult is about 45%. (But this can range from 24% – 64%). So 27.2% is within this range.
Are you on HIV treatment (ART) and what meds are they? And do you have access to your viral load result?
How about range for 27.2 % of 20 – 45 % please
Hi Dipak,
I can’t comment on your recent illnesses. However if you want to control your HIV you’re going to need to be on ARVs this is even if your CD4 count is high.
I am diagosed with HIV Positive for 7 years with CD4 436.
Today my CD4 is 699 with fluctuations 350-775 over a period of 7 years.
Still I am not on ART.
CD4% 29.2%
White blood cells 7100
Abs Lymph counts 2280 cumm
Ayrved supports me to maintain CD4.
Treatment are Bho Amli-Nirocil tab, Amla, Ashvagandha, Punarnava, Kariyatu, Galo etc.
But every Dec/Jan, I fell seriously sick for 20-25days with fever 102-103 F
Reason could not be diagnosed. Last year, I needed to be admitted to ICCU due to low SPO2 say 70.
This year also, I have fever for 15-20day
How to come out of yearly sickness ?
Not going on ART, is it right decision ?
Hi Dipak
Even though you have done very well to keep a high CD4 count for several years, please talk to your doctor about starting treatment.
All guidelines now recommended that everyone uses HIV treatment. This will be much better for reducing any future risks from HIV.
Hi Ash,
What HIV meds are you taking? Do you have access to your viral load result?
But in answer to your question, on average, the normal CD4 range for an HIV negative person is between 460 and 1600. This is an average. Anywhere in this range is good.
Although generally a higher CD4 is good, an HIV negative person with a normal CD4 count of 1200 is not more healthy than someone whose normal count is 400.
Please see more info here.
My cd4 count is 492…is it good or something worried about it.