Question
What is a normal CD4 count, CD4% and CD4:CD8 ratio?
16 January 2018. Related: All topics, CD4 and viral load, Other tests.
Answer
After finding out you are HIV positive, your doctor will run several blood tests.
One will be for your immune system and will include your CD4 and CD8 count. Of these, the CD4 count is the most important main result but the CD4% and CD4:CD8 ratio are also sometimes useful.
This Q&A include information about these cels and about interpreting the test results.
CD4 cells are a type of blood cell that is part of your immune system. They are a type of white blood cell (lymphocyte). CD4 cells are sometimes called T-helper cells or T-cells
There are two main types of T-cells.
- CD4 cells, also called T4 cells, are “helper” cells. They lead the attack against infections.
- CD8 cells, (T8 cells), are “suppressor” cells that complete the immune response. CD8+ cells can also be “killer” cells that kill cancer cells and other cells that are infected by a virus.
CD4 and CD8 counts
The normal ranges for CD4 and CD8 counts vary depending on the lab and test. 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.
The exact CD4 count is not so important. CD4 counts can vary from day to day and even from hour to hour. So the general CD4 result is more important than the exact number.
A normal CD8 range is from 150 to 1000. This test is not used as much but the results come together. It is more important to know your CD4 count than your CD8 count.
CD4 percentage (CD4%)
If you get a CD4 count that is ever unexpectedly high or low, then your CD4% (CD4 percentage) can show whether this is a real change in immune function. The CD4% is a more stable marker than the absolute CD4 count.
The CD4 percentage refers to percentage of total lymphocytes that are CD4 cells. If your test reports CD4% = 34%, that means that 34% of your lymphocytes are CD4 cells.
The average normal CD4% for HIV negative adults is about 40%. However, as with CD4 counts and other test, the range for a “normal” result in an HIV negative person is also wide – from about 25% to 65%.
CD4:CD8 ratio
The CD4:CD8 ratio is also sometimes used, but less often. This is a measure of how balanced your immune function is. This calculated by dividing the CD4 result by the CD8 result.
In HIV negative people, the normal range for the CD4:CD8 ratio is between 0.9 and 1.9. This means that there are about 1 to 2 CD4 cells for every CD8 cell.
When not on HIV treatment, just like the CD4 count and CD4%, the CD4:8 ratio drops over time. Eventually, unless you start treatment, there will be more CD8 cells than CD4 cells (i.e. the ratio drops to less than 1.0).
The CD4:CD8 ratio might be better at predicting future risk in people whose CD4 count is high (above 500 cells/mm3). However, not all studies agree on this.
Other studies have shown that starting ART soon after HIV infection has a much higher chance of keeping the CD4:CD8 ratio higher than 1.0.
Note: this answer was last updated in January 2018 from a post that was originally published in December 2006.
Hi Pradeep
If your partner is on treatment, then there is little risk to you:
http://i-base.info/qa-on-the-partner-study
If she is not on treatment, the risk from one time is very low – less than a 1 in 100 chance, maybe much lower still.
PEP involves you taking HIV treatment for a month in the hope this can prevent an infection.
Am fuck a girl she is positive hiv when I fuck condom break what can I do
Hi Margee, please ask your doctor, this site is only about HIV.
I do not have HIV but my CD4 is low and my CD8 is high does this mean my immune system is not working?
Hi Malik, the CD4 test can not be used to diagnose HIV. You need an HIV test for this.
Thanks for the information could any one here tell me how cd4 test can be carried out and can it be used to detect early hiv??
Hi Ajay, thanks for your comment which I have made into a new question. Pls see this link for the answer:
http://i-base.info/qa/12000
Hlo sir my father is affected by hiv
He is always time in depression
He don’t know that i also known about it.
What i will do?
Hi Cheri, It’s good that your son in taking ART, and that he talks to you about his test results.
However, the CD4 and CD8 results tell you how well the immune system is doing. If someone isn’t taking their meds correctly the viral load result is the test that can show it.
Your son’s CD4 and CD8 results are strong. The normal range for CD4/CD8 ratio is between 0.9 and 1.9. And the average normal CD4% for HIV negative adults is around 40%. Your son’s absolute CD4 count would be a good indication of the strength of his immune system.
However, if someone isn’t taking their meds correctly HIV will bounce back, and the viral load will become detectable.
There is much more about CD4 and CD8 ranges on the question above:
http://i-base.info/qa/20
Hello, my son is HIV positive and he always brings me his test results. I have to google what they mean so I can help him and encourage him. Because, I don’t really know what they mean. He is 24 years old and goes to his doctor’s care providers. Well, I am looking at his most recent blood test results and I am appointments on his own. So, I don’t have the opportunity to talk to his health confused about some of his results. His CD4/ CD8 ratio is 0.7 and highlighted to be low. His CD8 Absolute is 2196 which is considered to be high. His CD4 percent is 36.2% and it says this is low & his CD8 percent is 53.6 and is considered high. He has been on medication consistently for the last 2 years. He tells me that he is taking his meds everyday but from what I have read it seems like he may not be taking his meds consistently looking at these results. My question is from his results do these numbers indicate someone that may be taking their meds correctly? Or do they represent someone that needs to do better at taking meds consistently to better impact their results? Hopefully, you can help answer these questions.