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.
I started my medication in February 2019 and had sex with my partner 2 months later,and again this month what are the chances of him being infected, I am taking TDL drugs
Hi Ed,
Thanks. It’s great that Biktarvy worked so quickly for you. Biktarvy contains bictegravir which is an integrase inhibitor. This class of drug manages to reduce viral load very quickly.
Many countries around the world provide free HIV treatment. And other integrase inhibitors might be available cheaper or free in those countries.
I was diagnosed in 2012 i didnt start treament till may of 2019 my viral load has gone from 30000 to undetectable in 2 months i thank the new medication Biktarvy i suggest you ask your doctor if he hasnt proscribed it you do need to have good insurance it cost over 3000.00 but they do have programs to help
Hi Meme,
It looks like your CD4 count is strong. And do you mean your viral load is undetectable? If so, it looks great.
Here’s a link to Undetectable = Untransmittable (U=U).
Tested hiv+ 2018 October viral load 2500 cd4 1250
Started treatment 30th January 2019 cd4 was 990 no results on viral load, I went again for check up on the 13march cd4 1090 no results on viral load, I have been having sex with my husband without protection eversince he is still negative to date, is this usual??
Hi Thompson,
Which country does your friend live in? We may be able to help with regards to accessing ARVs.
Hi
Please help
I have a friend hiv positive and currently he’s Cd4 is 350. Due to supply shortage and he can’t take any more Arv tabs .. how many months or year will he survive before he die.
Hi Stombe,
Firstly as there’s been a risk, your partner is going to need to test.
If you are pregnant, then being on ARVs is what protects a child. They are able to drastically reduce the risk of transmission. Please see here: http://i-base.info/guides/pregnancy
Hi i tested HIV positive just recently on the 26 of April 2019 and i started meditation immidiatly and than last i had sex after with my hiv negative boyfriend with a condom and the condom burst and he is actually ready for kids. My question is how can i possibly protect my baby from getting infected?… thats if im pregnant.
Hi Anonymous,
The fact that your viral load has dropped from 134,000 to 1140 shows that the medication is working. Your HIV is beginning to be controlled, this is excellent news.
CD4’s can, and do fluctuate. Please see here: https://i-base.info/qa/424 This will change.