Question
How quickly does CD4 drop after being positive?
23 July 2022. Related: All topics, CD4 and viral load, Newly diagnosed.
HIV rapid progression question:
I got a positive test Feb 2022. My previous negative test was in Jan 2020 and I also tested negative in Oct 2019. They were full blood tests in an STD clinic not rapid tests so I believe they are highly accurate. I assumed I caught HIV in May 2021 as I had an exposure with a person who has since confirmed that he is also positive. Also I became very unwell at the end of May 2021 with seroconversion symptoms.
When my CD4 count was checked in March this year it was 57 and 7%. The doctor told me that such a low a CD4 count means I’ve been positive for a long time – as long as 10 years. Meanwhile I’ve been on ART since March and my viral load is almost undetectable now (last VL count was 43). My CD4 count recovered initially to 173/12% in early May but the latest count was 131/13%. Have you ever seen a case with such a rapid deterioration in CD4 count?
If I’m correct about May 2021 it means my CD4 dropped to 57 in 10 months. Or even if I caught HIV soon after my negative test in Jan 2020 it means my CD4 count got depleted in just 2 years. Thanks
Answer
Hi, how are you doing?
The speed of how quickly CD4 count drops depends on a number of things. The biggest factors are often the strain of HIV and your own immune system.
It is not uncommon for people to have the CD4 counts drop so quickly. Up to 25% can have. their CD4 count fall below 200 in just 2 years after transmission. In this case you are part of this 25%. This is explained further here. This is termed fast progression.
Others, on the opposite extreme can take 10 years before their CD4 count falls below 200. There is no way of knowing what determines how each person will respond to HIV. Though a more significant seroconversion period does indicate that CD4 count will fall quicker.
It is great that your treatment is working. A viral load of 43 is excellent and means you cannot pass on HIV via sex. Below 200 is considered undetectable for U=U to apply. The important number in your recent CD4 tests is the percentage which has gone up. The actual count can fluctuate between tests because of other factors inc. time of day, recent infection and exercise.
How often are you getting your CD4 count checked? CD4% is a better marker for how CD4 count is recovering and your medication suppressing HIV.
Josh.
Hello Sandeep and thanks for getting in touch.
The way I see it you either:
1. were within the window period when you tested – every type os test has a different window period that can range from 1.5 – 3 months
or
2. your result was a false negative – this can happen for many reasons including: expiry of the test, conditions it was kept, the quality and type of the test etc.
or
3. your body did not manage to contain HIV at all – we don’t all respond the same way to HIV and some have better immune systems than other, that can also happen.
How are you coping with your diagnosis?
I am sending you some information for people who just found out about their status:
https://i-base.info/just-found-out/
Hi i found myself in same situation. My last negative report in year 2024 was on june24: 2times, aug24, nov-24, then a +ve report on June -25 followed by viral load test.
Here strangely my cd4 count was 60 and viral load 3900000 the time I had very littile symptoms. Doctors said you were +ve since very long because Rapid test are not very accurate and it could not catch the disease. I asked why me +ve this time, he said bcs counts were too high. So what about peoples early detection. How my cd4 drastically dropped in just 6 months. can any one explain