Question
What does CD4, CD8 and CD4/CD8 ratio mean?
25 September 2023. Related: All topics, CD4 and viral load.
Hi, I was diagnosed on March this year, when I got diagnosed, I didn’t get tested for my Viral Load or CD4 count. 2 months in, I got my Viral Load tested with the result of 100 copies/mL. I just got my CD4 tested, the result is 243 cells/microliter, yes, below the 350 or 500 count sadly. My CD4% is 14.6 below the 29% threshold. However, my CD8 count is within the normal range, 984 cells/microliter. What does this mean? As my CD4/CD8 ratio is still below 1
Answer
Hi, how are you doing?
It is great that your viral load is now 100. Are you on treatment? If you are it shows that your treatment is working and HIV is being suppressed. A viral load of 100 is considered undetectable and means you cannot pass on HIV via sex, even without a condom. This is called U=U.
As you now have a suppressed viral load, this will allow your CD4 count to recover. Unlike viral load which responds very quickly to treatment, this is a slower process but it will start to go up. Have you been given an antibiotic called co-trimoxazole? While you have a weaker immune system, often people are given this to prevent other infections.
CD8 is not damaged by HIV. This is why this cell type is within a healthy range. Your CD4/CD8 ratio is less than 1 because it is determined by the number of CD4 cells divided by the number of CD8 cells. Most people should have a ratio of 1-1.9. This would mean you have 1-2 CD4 cells for every CD8 cell. Your ratio is lower because you are still waiting for your CD4 cells to recover.
Josh.
Hi Anastasia, it is great to hear the result of your viral load test. Thank you for sharing this news.
Dear Josh or Simon, or i-Base responder,
I just had a huge exciting news. As I told you in my last post, I decided to take my Viral Load at a reputable private lab which costed me 102 GBP. I just had the result last night and my viral load number is 24.5 copies/mL or 1.39 log copies/mL. The number is half of the upper threshold of the most common range for undetectable which is 50 copies/mL. I’m so happy and feel so vindicated that my viral load is factually much lower than what the free government-backed VL test program said it was.
My every-three-month quantitative VDRL test to check on my syphilis also gave back a “non-reactive” result. It has actually been “non-reactive” since July last year.
I feel so motivated and happy. I really hope that I can keep my motivation to stay healthy and my October viral load test will give a lower number than what it said yesterday.
Hi Anastasia, thanks, great you are staying on top of your results. Some countries run viral load tests in batches, so thee is a wait before testing, but anything other than a few weeks is not good enough. Perhaps the hospital could change this or at least given people good information about the process. Luckily, most people stay undetectable once levels drop this low. Good luck with your next test – and pls let us know how you get on.
Hi Simon,
I hope that you’re doing well as well. Thank you so much for the reply. I just got back from the doctor and she said, “you are as good as undetected”. I was so glad to hear that. I suppose in my country, CD4 numbers are more closely looked at compared to the CD4%.
In regards to my viral load, it was a matter of contention as well – as I have told Josh and wrote previously in several reply posts on this subsection. There’s this program in my country where we as PWH can get a free viral load test, yet the result took months to come out, and when I got the result, it didn’t have any unit of the number that came out. So, the October test result was 105 [something]. On the screenshot of the website from the program runner, it said that I was categorized as undetectable. My clinic told me that the unit is International Unit (IU). So maybe, my VL result is 105 IU/mL or 65 copies/mL, way below the 200 copies/mL benchmark.
Next month, I’ll be taking the viral Load test at a private lab which will cost me 102 GBP (not a small amount for me), so that I can get an assurance as to what my VL number is.