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.
Viral load is 539 and first test viral load was 50 and CD4 count rejected. What does thus all mean?
Hi Sali, how have you been doing for the last few weeks? It is great to hear that you have started treatment. Have you also started a medication called co-trimoxazole? This is an antibiotic used to prevent other infections as your immune system is recovering.
Now that you have started treatment, your CD4 count will be able to go up. Your treatment works by directly suppressing HIV. When suppressed, HIV is unable to damage your CD4 cells and your body will be able to naturally regenerate them. This is a process that can take time.
Unlike viral load which is suppressed within a month or 2, it can take a few years for your CD4 count to recover. Even though the progress can be slow, it will still go up. This is why using the antibiotic will help to stop you from falling sick as you are waiting for this.
I tested positive two weeks back with the cd4 count of 65,I started the treatment from day1of diagnose,do you think the cd4 count will recover soon?I am scared of falling sick
Hi Sera, how has your strength been effected? and has anything else changed recently that could have caused this e.g., poor sleep, not eating well?
Hello what should I do to get my strength back am so weak started tablets yesterday
Hi Doha, these results are reall good. Please tke care to keep taking the meds nd the result will continue for long time. How are u feeling?
My initial Numbers Were VL:860K CD4: 72. After 9 weeks on triumeq i got VL: 208 And CD4: 362 going from 7% to 23%. Is that good or bad?
Hi Christy, thanks, without more details it is difficult to comment, but any increase is a good sign that the meds are working. Your husbands viral load is now a more important blood test now he is on treatment. This should become undetectable over the next few months and might already be undetectable now. This depends both on how high it was at the start and which meds he is taking.
My husband went from 200 to 220 in a month is that good
Hi J, thank you for sharing. It is always inspiring for people to read about stories such as yours that show how well medication works.