Question
Why has my CD4 count dropped a little?
24 August 2023. Related: All topics, CD4 and viral load.
Hello there,
I have been HIV+ since October 2021 when I was diagnosed with a low cd4 count of 124.
However after about a year of treatment (Biktarvy) my CD4 count increased to 379 in August 2022.
Today was my first CD4 test since that time and i’m very very surprised to see that my CD4 has dropped to 340. My CD4 Percentage is still the same and the rest of my blood test was perfectly fine.
How is that possible that my CD4 has dropped that much in 1 year? Feel like it was 1 year for nothing and it’s kinda sad…
I didn’t sleep much the night prior to that blood test and felt a bit of stress. Could that be the reason of that decrease?
Regards
Answer
Hi
It is great that your CD4 count has been able to recover in the last few years. You are doing really well.
Because the test only gives a general result, your doctor will see both results as being the same.
It is more important that your CD4% has remained the same. This is a much better marker of your immune system and shows you that your treatment is still working.
Your CD4 count also fluctuates. It can change through the day making it unreliable at showing how your immune system is doing. CD4 count can be effected by recent exercise, when you last ate and if you have had a recent infection.
CD4% is much more stable and as it has remained the same it shows your immune system has not really changed.
Most people get the biggest CD4 increases in the first year on treatment. After this the increases are steady, but much smaller.
Josh.
Hi Nicolas, as your CD4% has not changed how you had been feeling before this test likely explains the drop in the absolute count.
Having a stable CD4% would suggest that you do not need to have a CD4 test sooner than 12 months. As you are doing well on treatment and your immune system is recovering you can next test when scheduled in a year.
Hello and thank you for your response. I did this test in the early morning and didnt eat for 12hours before that because they were testing my cholesterol as well. I had exercise the evening before and it’s true that I was feeling off/I’ll until 2 days before that bloodtest (feeling sloppy and sore throat).
Maybe that and the fact that I had a stressful night where I slept only 3 or 4 hours have made my cd4 count to drop when I tested it.
Should I ask for re test of my cd4 in 6 months instead of 1 year ?
Thank you for your time and for your help !