Question
How long will my CD4/CD8 ratio remain below 1?
27 September 2023. Related: All topics, CD4 and viral load.
Dear all,
May I inquire about the duration during which an untreated patient will have a CD4/CD8 ratio of less than 1? Is it 1, 2, 5 years or more?
I understand that CD4 levels can vary among individuals, but could you provide a general overview of the big picture regarding them?
If the patient starts treatment, how frequently can the ratio be expected to return to normal (more than 1)? I understand that the ratio may not be of paramount importance, but I am curious about it.
Thank you
Answer
Hi, how are you doing?
As you have stated, it is difficult to say among individuals due to how variable CD4 count is. This means I cannot provide a general value for a bigger picture.
In most cases it can take between 2-10 years for CD4 count to fall below 200. Outside of this it can be within months to more than 15 years.
A CD4/Cd8 ratio is determined by the value of CD4 cells to CD8. There should be 2 CD8 cells for every 1 CD4 cell.
Starting from a lower CD4 cell count it takes longer for the cells to recover. As an example it can be less than a year to go from 400 to 500, but from 100 to 500 it can take multiple years.
The ratio is not often used clinically because it doesn’t offer too much information about how your immune system is functioning. If you naturally have a lower Cd8 count it can provide a skewed result.
Josh.
Hi Ksp, there can be big differences between how different people respond to HIV. For some, the CD4:CD8 ration can drop belwo 1.0 very erly and for others it can stay above 1.0 for many years. The CD4 count is usually a better marker than the ratio. Also, if on HIV treatment (ART) knowing that viral load is undetectable.
Neither result can be used to show HIV infection though.
A negative test is very accurate – you do not have HIV.
After how much time of hiv infection , cd4 cd8 ratio will be inverted? I mean when cd4 cd8 ratio will be less than 1 after infection?
Is it possible that someone is infected almost 7 years ago and still the 4th gen test gives false negative test?