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 Joan, thanks for the nice feedback and great you are getting such good results on treatment. There is no statistical difference between viral load of 20 and 35. At such low levels this just shows variability of both viral load and the limits of the test. If you tested exactly the same blood sample twice your could easily get these two different results. In the UK, so long as viral load is under 50 copies/mL there is nothing to be concerned about. In the US, doctors don’t worry about any fluctuation that is less than 200 copies/mL.
Hi,
Your responses to questions are quite impressive. Keep up the good work.
I have a question – I have been on HIV drug for over a year and my last test result shows that my CD4 count is 375 , but my viral load increased from an Undetectable rate of 20 to 35. My question is…why does my viral load increased while i am taking my drug and do i have to worry?
Hi Raja, please look at Q2 at this link:
http://i-base.info/qa/what-are-the-most-asked-questions
Hi. My cd4 is 296 so how to take preacautions for to be incresed the cd4 is it serious our what may be informed the situation.
When you start HIV treatment your viral load gets to undetectable levels quickly. And once this happens your CD4 count usually goes up. But it’s also usual for the CD4 count to rise slowly. During this time CD4 counts can go up and down too.
If you have an undetectable viral load it shows that the treatment is working. You can talk to your doctor about your worries just to make sure.
Hi, Can you please clarify, my CD4 is 380 and viral load is undetectable. I started treatment in 2015 June with a CD4 of 328 should I be worried.
Hi,
It is great that you have started treatment. Your CD4 should slowly start going up. You can find more information about starting treatment here:
http://i-base.info/guides/starting
Hi my cd 4 count is 16. I have started the treatment in a week us my cd gonna go up?
Hi
This service is not run by doctors. i-Base is a treatment information service and the info we provide to to help when you are talking to your doctor.
There are no foods or supplements that will increase your CD4 count. Only HIV meds (ARVs) can do this.
Your current meds are unlikely to be working and your doctor should be talking to you about a new combination. Talk to the doctor and nurse about your difficulty skipping the first meds. You need to find a way not to do this with the new combination because you will be relying on these drugs to get your CD4 count to increase to safer levels.
hi doctor i started taking treatment in 2010 but i was skipping my treatment but recently i went to the hospital and my cd4 count was 7. what can i do as i dont smoke and i exercise regularly. what food can i take and supplements to increase my cd4 count