Question
Why has my CD4% not gone up?
6 December 2023. Related: Adherence, All topics, CD4 and viral load.
Hi,
I had my 6 monthly check up on Thursday, and received my results back today.
My CD4 count was 206 and has gone up to 269. However, my CD4 % has stayed at 13.3%.
Is this something I should be worried about? Feel a bit down because of it. Expected it to be higher.
Thank You
Answer
Hi, how are you?
Sorry to hear that you are feeling a little down.
How long have you been on treatment? and what your CD4 count when you started?
CD4 count can take a long time to go back up. Unlike viral load which can change within weeks, CD4 count increases slowly over time and can take a few years to return to a healthy range (430 and 1690).
What’s your viral load? If this is still suppressed/undetectable it proves that your treatment is working.
CD4% is more tightly controlled than the absolute count. The actual count can fluctuate more because of recent infections or vaccines and even the time of day the blood is drawn. The CD4% is not affected by this.
This also means that a small increase in the absolute count will not always correlate with an increase in CD4%. This doesn’t mean there hasn’t been an increase, just that it wasn’t a big enough increase to shift the CD4%.
Don’t be discouraged by this. The count has gone up and it is going in the right direction. Starting from a lower number can mean that recovery does take longer. Sticking within medication and continuing with your 6 monthly check ups will help to see this number increase.
Josh.
Hi Dan, good to hear that you have been feeling fine throughout the year.
Great that you have now been able to stop co-trimoxazole. Your CD4 count is trending upwards and is now more stable.
An increase of 200 since starting is very encouraging and suggestive your CD4 count will recover to within a healthy range (430 – 1690).
Been fine throughout the year. A few aches here and there, but no major problems.
I started with a CD4 of 62 then I had another test and it was 206 then my latest is 269.
I’m not on co-trimoxaole anymore. In England, you stop co-trimoxaole once your CD4 reaches 200.
Hi Dan, it is great that you are undetectable. How have you been doing over the last year?
Have you had any further CD4 tests in the last year? and are you taking another treatment called co-trimoxazole?
CD4 count goes up slowly after starting treatment. Unlike viral load which responds immediately, CD4 count can take a few years to recover. This is why co-trimoxaole is used to help assist your immune system as you are recovering.
As you are undetectable it shows that HIV is not damaging any more CD4 cells and your body will be able to naturally recover over time.
I’ve been on treatment a year in January 2024 and my cd4 when diagnosed was 62. I’m still undetectable.