Question
Why does my CD4 count change so much?
8 September 2006. Related: All topics, CD4 and viral load.
I discovered I was HIV-positive in July two months ago. My viral load was 127,000 and my CD4 count was 430. I had a recurrent sore throat infection and recurrent swimmer’s ear infection.
Two weeks later my CD4 count test was 529. One month later (in September) my CD4 count dropped to 283.
I am so confused when my CD4 count changes and drops so quickly. I don’t know when is the right time to start my treatment because I think my CD4 count might increase later without treatment. Why does my CD4 count change so fast? Can this be dangerous? Do I have high risk of OI anytime?
Answer
When you are first diagnosed with HIV, the results from CD4 tests can be worrying, especially when they changes from one month to another.
If you were to have a test every week, they would probably change even more. For example, your CD4 count is generally 50 cells higher in the morning compared to at night, and can be affected in a similar superficial way by diet and exercise and other infections.
None of these small variations mean anything in terms of your general health and immune system though.
However, the most important thing now is that you talk to your doctor about starting HIV treatment (called ART). This is now recommended for everyone who is HIV positive. your CD4 cont on ART should then increase, but it will still sometimes be higher or lower.
The risk of OI’s generally increases once your CD4 count falls below 200 cells/mm3. A few can occur at higher CD4 counts – skin problems and susceptibility to food and water-bourne parasite can occur between 200 and 300 cells/mL.
Starting ART will stop the risk of OIs in the future.
Also talk to your doctor about you throat and ear infections, though they are unlikely to be related to HIV.
Note: This answer to a question in September 2006 was updated in February 2019. the update was that HIV treatment is now recommended for everyone.
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