Question

How to interpret blood results including CD4%?

13 March 2008. Related: All topics, CD4 and viral load, Newly diagnosed, Other tests.

Hi I was diagnosed hiv+ in July 2007. I went to my clinic Jan 2008 to have my tests and the results came back 460 cd4 and 300,000 viral load. My previous test 3 months earlier was 520 CD4, 1 million viral load.

My doc told me it was a significant drop in viral load, and also told me that my imune percentage was 13% which in her terminology isnt good and I’d have to consider treatment on my next apointment.

My question is if the CD4 is ok, and the viral has significantly declined, why must I consider treatment?

I know CD4 isnt 100% acurate reading because there are diferent blood cells that do different things. How does immune percentage work as regards to treatment because I think my viral and CD4 are ok! but apparently they are not good ,and my percentage is being taken into account now….

thanks…

Answer

Answer: Simon Collins

Hi – thanks for posting your question and letting us answer this online.

First it is important to know more about when you think you caught HIV, because two different examples could explain your results.

If you think you were infected last year, and that your tested shortly afterwards, then you dont need to make any decision about treatment now. You can monitor with CD4 and viral load tests every month or two to get a better idea of what is happening. Your viral load could continue to drop and your CD4 count and CD4% (immune percentage) could improve again by itself.

Because you have such a high CD4 count and a high viral load, this would easily explain these results, and the difference btween a CD4 count of 460 and 520 is not something that your doctor should be worried about. It is easily within the bounds of normal flucutation.

If however you think you may have been HIV-positive for many years, then it may be more important to look at the viral load results. A very high viral load (over 100,000) in chronic infection (ie long term infection) is an indication to start treatment. Again though, becasue your CD4 count is still strong, this isn’t so urgent that you can’t take time to get another set of results now, and again in another month, just to confirm everything.

Although the difference between 300,000 and 1 million sounds a lot, your doctor shouldn’t interpret this as a significant change until additonal results confirm whether this is a real change.

Finally, ‘immune percentage’ is also called CD4% and refers to the percentage of white blood cells that are CD4 cells. 40% is normal (ie in an HIV-geative person) and 12-15% is roughly the same as a CD4 count of 200). See here and here for earlier answers about CD4%.

Your CD4% is still pretty good. If you have had HIV for many years, then with a viral load over 100,000 it would be reasonable to think about treatment. If this is a recent infection then all your results could get improve by themselves and you may not need treatment for many years.

Either way, you have time to get at least one, and preferably two news sets of blood results, so that you can make an informed choice based on a bit more solid information.