Q and A

Question

Why has my CD4 count reduced while i’m on medication?

I was diagnosed with HIV in November 2020 and since then I started taking Atripla. At diagnosis my CD4 count was 290. It increased to 501 in June 2021 but since June I have tested twice and it has been decreasing (450 in September and 430 in December). I am very worried about the constant decrease since June. Is it normal or should I be worried?

Answer

Hi, how are you doing?

CD4 counts are not a fixed value and can fluctuate. As an example the number increases after exercise, but will be lowest when first waking up. Your test results may reflect this and the apparent decline may just be a result of external circumstances.

A CD4 count of 430 is still a good number. Anything above 350 reduces risk of infection and shows your immune system is still working well. CD4 count is not the best measure of your immune system, have you heard of CD4 percentage? This is a more accurate representaiton and is better at identifying changes in your immune system. This link will help explain this further.

Do you know what your viral load is? This is often a better indicator of how your medication is working and if HIV is being managed. I imagine watching your CD4 count reduce like this can be worrying but you are still in a healthy range.

Please send in any more questions you may have,

Josh.

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