Question
What do it mean if your CD4 count is 200 or less?
5 February 2018. Related: Access to treatment, All topics, CD4 and viral load, HIV transmission, Starting treatment, Support.
My partner did her first CD4 test this December and it turned out she had a CD4 count of less than 200. She got to know she was positive in April when I also got to know her. Her viral load is not known as that test is rare in developing countries.
My questions are:
1. What are the things you read or come to your mind if someone’s first test is a CD4 count of less than 200?
2. Speculation is not good but since we cannot accurately estimate time of infection then we may only speculate with some backing of scientific HIV facts. Approximately how long does an infection lead to a CD4 count of less than 200 if we can speculate :) ?
3. We do not know who was infected first but my CD4 count since April has been above 650 and my viral load is 1200 from a last test this week (I am not on any medication yet). What do you read or what can your more reliably assume from a comparison of our data?
4. She started medication but I have my fears as we are from a developing country medical access has been very hard for her.
Thanks
Answer
Thank you for your question.
How are you both doing? Even though finding out you are positive can be difficult, it does get easier. Effective HIV treatment (ART) is now widely available even if access to some tests (like viral load) is sometimes more difficult.
Answers to each of your questions are below.
- A CD4 count of 200 or less is a sign that HIV is more advanced. This means it is more important to start ART. This is because once the CD4 count drops below 200, the risk of other infections increases. Until the CD4 count becomes higher, using a daily antibiotic, combined as co-trimoxazole (often called Setrin or Bactrim) prevents pneumonia and other infections. For more information on CD4 count and the risk of becoming ill please follow this link.
- HIV affects people very differently. Even if two people both become HIV positive with the same virus at the same time, one might progress very quickly and the other very slowly. There are also no tests that can show how long someone has been HIV positive. Even if there were a test, the most important thing for both of you now is looking after your health and looking forward to the future.
- As with question 2, it is impossible to know who became positive first and for how long. As above, the most important thing is to focus on both of your health. Ift is good that your partner is already on ART as since 2015 this has been recommended for all HIV positive people, even with a high CD4 count (above 500). Even though your CD4 count is currently strong, please talk to your doctor about this. Your risk from HIV are currently low, but being on ART reduces these further. Good information can help when talking to your doctor. For example, please see the i-Base Introduction to ART guide.
- Some countries definitely have fewer choices of treatment and related tests – although this is getting better. Even when viral load is not available, the meds will still work for your partner though.
Note: this answer was updated in February 2018 from a question first posted in December 2010.
Although I don’t know your circumstances, the fact you are both positive should not affect the attitudes that your doctor has to having a child. The doctor not having this experience is also not a good reason. The only difference in this case is that you are both wanting to plan your pregnancy with your doctors support.
In many cases people just find out they are pregnant without specifically trying for this, and in this case the mother and baby are treated for their own health and to minimise the risk of transmission. This mainly involves the mother starting ARV treatment to get an undetectable viral load for when the baby is born.
It the doctors think you would make good adoptive parents, then they are not concerned that having children itself is a problem. This used to be the case before ARV treatment when doctors worried about the impact of a parent dying early. That concern continued as prejudice for many years and perhaps this is part of the case with your doctor now.
If this is not the concern, your doctor should focus on the dramatically reduced risk of passing HIV to a baby when the mother in on treatment. Your partner’s HIV status does not have any direct relationship to the HIV status of the baby.
Perhaps print out this page and the information in the links that it included and take this to your doctor. There are also extensive guidelines for treating HIV during pregnancy, including in the UK and US, and your doctor should be aware of these.
Please let me know if you have other questions.
Thank you simon collins for your reply when ever we consult doctors they discourage us and suggests us for adoption. They have not see both partners who are hiv+ and who have a baby.
It is relatively easy for a couple to have children if they are both HIV positive. The main thing to monitor is that the woman’s HIV viral load is undetectable during the pregnancy and especially during labour. This will reduce the chance of the baby having HIV to less than 1%.
Please speak to your doctor about this and if your doctor is not helpful, talk to an HIV association or a new doctor. Lots of couple become pregnant without involving their doctor without planning this, but it is better for your doctor to support you.
The i-Base guide to HIV and pregnancy includes lots more information including a section on getting pregnant when you are both HIV positive.
Me and my husband both are hiv+. My CD4 count is 1100 and my husband’s CD4 count is 200. Both of us have been on meds for last 5 years. Can we have kids in future?
What does your sister want you to do? Perhaps talk to her and find out?
Of course it is important to be supportive, but she can still lead a full and active life.
Her CD4 count is good and she can have children if this is her choice.
HIV meds dramatically reduce the risk foe the baby to be HIV positive.
I have a sister with a cd4 395 .What should we do?She is single and never been married.Is she able to have children?
A CD4 count of 456 is very good. This lady will not need HIV medicines until her CD4 count is around 350. There are medicines for HIV which she will have to take for the rest of her life but will give her a near normal life expectancy and a good quality of life. For more information please read our guidebook by following this link.
One lady has a CD4 count of 456. What should we do? Is she in danger or not? Can medicine save her life? Please give me as answer and let us know if we are in great.
Please help ustrouble
Hello,
Thank you for getting back to me. These drugs are very effective HIV treatments. For more information about them please follow these links for Combivir and efavirenz
Hello Charlotte I just got information that the drugs she is taking are CBV and EFV. When I try a search I find that the terms refer to efavirenz (EFV) zidovudine/lamivudine (CBV).
Could you please advise on the effectiveness of these drugs and things to watch out for about them. Many thanks