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.
Hi Neno,
Everybody has CD4 cells, whether they have HIV or not. But generally only HIV positive people have their CD4 counts checked, and somebody who is HIV negative would usually have a CD4 count between 500-1600.
A CD4 count of 221 doesn’t mean this person has AIDS, but it does mean they should be getting treatment for their HIV. Are these your test results?
Please see our guide to starting treatment for more information.
if a person CD4 is 221 or above is it true that that person is infected with HIV or CD4 count is for the people who have HIV and aids and it can be counted a person who is HIV negative
Hello Chisom,
We are not doctors and I cannot diagnose your patient. In the UK the usual practice when a doctor has a difficult case is to consult with other specialists. This can usually be done in person, or via email or phonecalls.
Hi! I have a male patient whose CD4 count is 820. Studies revealed that he has no infection but he is very sick and the symptoms are manifesting clearly on him. He has oral thrush,herpes simplex, recurrent penile ulcer,bony prominences,emaciation and exophthalmus. He’s currently on 1st line ARV drugs and co-trimoxaxole(Septrin).I don’t want to loose this patient because i’ve been managing him for a long time. Please, what could be the actual problem?
Hi Phumzile, I’m very sorry to hear about your sister’s diagnosis. Although her CD4 count is very low treatment should still work well for her. Because her CD4 count is under 50 there is a risk of something called IRIS. This may mean she gets more ill to start with, as her body starts to fight back. It’s important to tell the doctor about any symptoms she has so that she can be well looked after.
Everybody progresses at different rates. So it’s difficult to say when she will have a CD4 above 200. This link will show you the average CD4 increases after starting treatment.
Hi Tebello, I’m sorry that you are so worried. But don’t panic- HIV treatment is very effective, even with low CD4 counts. It’s important that your partner starts treatment as soon as possible. If he is already on treatment he may need to change to a different combination. The only way to increase your CD4 count is to use ARVs.
My sister has just found out she is hiv positive and her CD4 count is 3 and she has just started on her treatment.She has headaches, dizziness and vomits.She is sick, is she going to get really really sick, how long will it take her CD4 count reach 200 or more.
Hi there. I am HIV negative, and my partner has been positive for the past 17 years. He went for a check up last week as he has been feeling very drained and found his CD4 count to be only 87. I am in panic mode. What can I do to help get the levels up again?
Your partner’s CD4 count is still pretty good. However, all treatment guidelines recommend using ARV treatment when the CD4 count drops below 200. If your partner is already on treatment this should help the CD4 count increase.
Cotrimoxazole is a combined pill that includes two antibiotics. It is prescribed to HIV positive people as a general protection against a range of infections. In some countries this is recommended as long as the CD4 count is below 200. Other countries though recommended staying on cotrimoxazole until the CD4 count is above 350, including I think in South Africa.
This just refers to the use to prevent infections. If your partner has been prescribed this for an active infection then use may be different. so talking to your partners doctor together will explain why this is used in your case.
my partner has a cd4 count of 175 and is taking co-trimoxazole and i an HIV neg what does this mean to me and him but i am very worried