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.
When hiv positiv peson reach undetectible level of virus, where is remaining virus located in our body?
Why it is untouchable from medical side?
Can this small amount of virus can destroy our cells, except cd4? For example brain cells?
Hi Mickey, yes do keep us posted with results. It is a good sign that your CD4 count has already gone up from 240 to 250. While this may seem small, CD4 recovery takes time and this increase is encouraging. This increase suggests that your CD4 count will continue to rise over the next 3 months with a higher result.
Hi Josh,
I don’t know current number of CD4. 2 weeks ago, it was 250. I am on ART, next check will be in 3 months..
Also, I dont know number of CD4 before infection.
I will send update when I check new staus. I hope that I will have improvment !
Hi Mickey, what is your current CD4 count? Different countries will have different recommendations on when to be taking antibiotics. Do you know what your CD4 count was before HIV? It would be possible for your CD4 count to be higher but this isn’t important. While on treatment your CD4 count can recover to a healthy range (between 430 and 1690). As long as your CD4 count is in this range, your immune system is healthy. Having a CD4 count of 500 and 1000 will not change how functional your immune system is. It is still healthy.
Hi,
Im from South Europe. Doctor didn’t tell me anything about antibiotics..
I will have first follow up with doctor in twoo weeks and I will ask about antibiotics. Specially, because I have annoying cough during the some period of day.
Also, I plan to go on holiday in USA… in 20 days..
One more question, is it posible to reach higher number of CD4, than the number we had before infection?
Thanks Josh for quick answer.
Is covid vaccine (4th dosse) recommended?
Specialy in first few weeks of therapy?
Is it recommended to take some antibiotics, when my CD4 is around 250?
Hi Mickey, please follow this link for more information about the vaccine: https://i-base.info/qa/16330
Where are you? Some countries will suggest people be on antibiotics with a CD4 count below 200 while others suggest 350.
Hi Mickey, having CD4 fall quickly after infection is not uncommon. It will also depend on what your CD4 count was before testing positive. The range for a normal CD4 count is between 430 and 1690. If you had a CD4 count closer to 430, it would be easier for your CD4 count to fall so quickly.
Starting treatment is excellent. It will allow your body to naturally recover your CD4 count. HIV treatment suppresses HIV and it stops HIV destroying CD4 cells. This can be a slow process e.g., it does not happen as quickly as viral load is suppressed. As you are starting soon after exposure and your CD4 count still remains above 200, recovery to a normal range is expected.
Hi, I’m tested positive 5 days ago. Last test was in November 2022 and it was negative.
During december ad January, I hade symthomes similar flu.
Doctor told me that I was probably infected during November.
Viral load is 14000, but CD4 is only 240.
Why is CD4 too low if infection discovered in early stage?
I’m starting with medicals today, Tivicay and Gilestra Duo
Mickey
Hi Leonard,
HIV treatment (ART) is taking ARVs (antiretroviral drugs). So it’s great that your partner is taking them. But yes, once you start taking ARVs you have to continue taking them so they keep working.
Please ask your partner to talk to her doctor about this treatment. It’s important to take it the right way.
What country do you live in? There could be local support organisations there.