Question
How quickly will my CD4 and viral load change after starting treatment?
25 January 2019. Related: All topics, CD4 and viral load, Starting treatment.
I started ARV (efavirenz and AZT 3TC) three day ago. My CD4 count is 50.
How long do i need to wait for my treatment to bring up my CD4 count above 200 and to get my viral load undetectable?
Are there other treatments to bring up my CD4 count more quickly?
Answer
There can be a wide range of responses to treatment in terms of the time is takes to see changes in your viral load and CD4 count.
In general, viral load falls more dramatically and more quickly. It may drop by 1 log in the first few days of treatment and by another log in the next week or two. A ‘log’ is a factor of 10, so if your viral load drops by 2 logs, it is like knocking the last two digits of your starting level: i.e. getting from 100,000 down to 1,000.
If this is your first treatment, your viral load should drop by a minimum of 1 log over the first month, Actually, if your combination includes an integrase inhibitor, many people become undetectable (<50 copies/mL) within the first month. or many people will be undetectable. Nearly everyone else becomes undetectable within three months.
The time also depends on how high your viral load is when you start treatment. If you starts very high (over 1 million copies/mL) then it may take up to 6 months. Some people starting treatment in very early infection with viral load this high might even take 12-14 months to become undetectable.
However, if you don’t see a similar rapid drop at the start, or if it starts to go higher again at any time, your treatment may be failing.
CD4 counts respond more slowly, but there are also a wide range of responses in different people. It could take a year for you to get back over 100, and another year to get over 200. Although this may seem like a long time to you, because the trend is increasing, your immune system will also be getting stronger, and people don’t generally develop new infections as the same CD4 count, when they are starting treatment, compared to people at the same CD4 count who are not on HIV treatment.
You may find that it increases much quicker than this – some people get early dramatic increases, but a slow steady increase is probably better.
There are not really treatment that make your CD4 count increase more quickly. HIV drugs work by reducing your viral load first, so that your immune system recovers by itself afterwards.
This answer was updated in January 2019 from a question first posted in August 2006.
Hi Palesa,
As long as your viral load is undetectable, which is should be because you’ve been on meds for a year, then there isn’t any risk to your partner. Please see the following:
http://i-base.info/htb/32308
Hi all,
I am living with the HI virus and when I started my treatment, my CD4 count was very very low,it was 115. I started taking my treatment thereafter. Its been one full year now that I’ve been taking my treatment. I’ve remained single until recent, my partner (who is negative) and I had unprotected sex twice first time I was on my first days of my periods and secondly we had had recently. I NEVER miss my tablet nor get sick.
My question is:
1. Now that when we had it for the first when I was on my periods, could I have infected him?
2. What are the risks of having unprotected sex while on medication, for me? Can I get sick or the tablet will stop working.
We love each other so much, that we are even talking about marriage and children.
But I am really scared to stay long in this relationship because of my status. I always talk to him about the HI virus, and he seems to be on and off about the situation.
Please take note I’ve been taking my partner for one full year and I’ve never missed a day.
I’m worried about him if he might have got infected, and me too that the tablet might stop working, I might change a regime.
He went for an HIV test, after we had unprotected sex while on my periods, it came back negative and I’m still on my medication. Again recently we had unprotected sex.
Am I being reckless? Thing is his a Bishop (spiritual person) so am I, and he does not believe in taking tablets.
What more can I do to keep him safe and make sure when we do have our baby he remains negative, or can he be infected??
Your response will be highly appreciated.
Hi Ayoli, please talk to your doctor about how you feel. It will be fine to start meds again, but you doctor needs to talk though the reasons that you stopped. This is only in case there are reasons that he or she can help with. You have been lucky so far not to have become sick, so it is good that you want and are ready to go back to meds. Good luck with this.
I started my arv 2015 May while i eas pregnant somy baby will be negative, my health was good and am very fat,i dont get sick easily even flu itself, and 2016 April i stopped taking meds, i don’t have any problems no sickness i want to start taking my meds again am scared i might be sick and die
Hi Akash,
Your CD4 has improved a great deal. You’re doing great. Your HIV is controlled.
I came to that i am hiv+ in October 2016 and at that time my cd4 count was 292 but after 6 month of medication my cd4 become 783 in April 2017. Is it sufficient to lead a healthy life?
Hi Wisdom,
To know for sure you will need to have some more blood tests done. You need to have your CD4 checked and your viral load.
i was diagonised in a different healthy facility, and i was told am positive and started treatment but when my docter come after six days find me negative with many different methods, now i ask my self which method did the other healthy facility used or could i have an high sensitive immune to be detected negative? what can i follow?
Thank you!
i find this very helpfully and will always use it in future .