Question
Why has my CD4 count dropped by CD4% gone up?
11 October 2023. Related: All topics, CD4 and viral load, Newly diagnosed.
Hi! How are you?
I recently took my tests after 6 months and my viral load remains undetectable but my CD4 count went from 681 to 407 /mm3. Though in percentage it went up from 25% to 26,93%. I’m a bit confused about this.
Should I be worried? What could cause this drop in such a short period of time if my VL remains undetectable which means the treatment is working?
Answer
Hi, how are you doing?
No you do not need to be worried.
As your viral load remains undetectable your treatment is still working.
It is more important that your CD4% has gone up. This is a more accurate measure of the health of your immune system.
The actual CD4 count number can change depending recent infections/vaccines, exercise and even the time of day your blood is drawn.
Do you know when your next test is?
Your first result of CD4% of 25% does not quite match the actual CD4 count you had. It would be expected that your CD4% is greater than 29% for an actual count above 500. As your percentage is going up it shows that your immune system is recovering.
Unlike viral load which changes rapidly after starting treatment, CD4 recovery is a slower process but it is going in the right direction.
Josh.
Thank you for your rapid answer, Josh.
I’m taking another test in 3 months. My doctor recommended taking the tests every 3 months instead of 6.
I started my treatment back in nov 2019 with a Cd4 of 17/mm3 which was 1,4%. The test I took 6 months ago indicated a cd4 of 681/mm3 and 25% indeed. Ratio cd4/cd8 0,80. I also thought the percentage was low when I saw the number of copies and I was expecting it to grow higher but it didn’t. Anyways I’m much more calm now that I know that if the percentage grows, it’s ok.
Hopefully next time the number will go even higher. I usually take the test as soon as I wake up and on a empty stomach but now that i’ve read more things about it I’ll try to change the time of the day I take the test next time.
Thank you again for all the work you do on this site. It has helped me a lot during this ride.