Question
Why has my CD4 count dropped when I am on treatment?
26 May 2011. Related: All topics, CD4 and viral load.
Hi
I’ve been taking Atripla for 1 year now. I started my medication 3 years after been infected as my CD4 was 349 at the time. I got my bloodwork results today. My CD4 is the lowest it has ever been at 239 and my viral load is undetectable. When I experienced seroconversion a couple of weeks after being infected, I felt as though I was slipping away, it was horrific. I have heard that some people can go for years without with medication their CD4 becoming low and their viral load becoming high. Some people haven’t experienced seroconversion, well, at least not as signifigant as I suffered. Fortunately, I have not been ill since apart from a cold and other normal stuff. I’ve heard that there is a type 1 and type 2 strain of HIV. Do you think that I have a more agressive strain of HIV?
Also, if my CD4 is 239, should I be concerned? Should I expect to get ill soon?
Many thanks
Answer
Thank you for your question.
It is very common to experience CD4 fluctuations. this may be the case now even though one result is much lower than the other. Once you are on treatment the most important thing is that your viral load remains undetectable.
There are 2 different strains of HIV. Very few people have HIV-2 which is a much less aggressive strain and found mainly in West Africa. Most people have HIV-1. Your CD4 fluctuation would not be as a result of the type of HIV you have. It also does not mean you are going to become ill again. A CD4 fluctuation is very different to seroconversion.
For more information about CD4 count fluctuations please follow this link.
Some people on treatment though do not get a CD4 increase. This perhaps affects up to 10% of people and the reasons are not known. If your CD4 percentage (CD4%) is relatively high (22% is about the same as a CD4 count of 350 and 12-15% is about a count of 200) then this still gives you good protection against infections.
Research is also looking at other ways to explain why CD4 counts do not always increase, so there may be more treatment options for this in the future.
Hey am a lady aged 39yrs,i have been o ARVs since 2012 then my cd4 count was 68,then 148, 248 then dropped to 198,since last year it flactuates between 180 and 250 but the viral load is undetectable, so how do I get to raise my cd4 count other than ARVs, are there any recommended drugs to boost the cd4 count
Hi Alex,
CD4’s can and do fluctuate, therefore unless your viral load is increasing this isn’t something to worry about. Please see the above.
I am on HIV med’s for the past five months but my cd4 count has drop from 467 to 423 but has gain weight. What does it means I’m really concerned about it.????
Hi Nicholas, It’s good that you’re feeling ok now. Can you check with the doctor about your results? A CD4 count is strong. So if viral load is undetectable the meds are still working.
Ok. I have been feeling ill for the last 2 weeks, got kinda bad in the last week of the 2 and now I’m back to feeling ok. But I had a doc appt to follow up on how my treatment is going for hiv and I found that my CD4 count dropped by nearly 1,000. 1,700
In September and now 800. Is this a sign of a relapse or reinfection? I had nearly all of the symptoms when I was not feeling well for 2 weeks
Hi Joseph, A CD4 count of 844 is strong, and it’s well within the range for normal even for people who are HIV negative. Please see questions 1 and 5 here.
Hello there, just was wondering why my cd4 fell from 1148 to 844 in the past three months. Is this something to be concerned? My cd4% actually went up from 45.2 to 47% a loss of 400 seems like it may have been a false reading. I’ve been as high as 1303 tho back in May of 2017.
Hi Millicent,
Its not possible to say how long it will take for your CD4 count to rise.It will however be rising as you’re on medication. Your viral load will decrease much faster which is good seeing as your partner is negative.
HELLO I’M A LADY OF 25 YEARS OLD I FOUND THAT I’M HAVE POSITIVE IN 2013WHEN I WAS 20YEARS OLD…I IGNORED THAT..AGAIN GET TESTED IN 2016 STILL FIND POSITIVE AGAIN IGNORE…I GOT A NEW PARTNER LAST YEAR JUNE WE AND WE WERE NOT USING PROTECTION, THIS YEAR JANUARY 2018 WE BOTH GO FOR BLOOD TEST HE WAS NEGATIVE AND ME POSITIVE. I STARTED ARV’S EARLY FEBRUARY AND MY DC4 COUNT WAS 222. SINCE I TESTED AND FIND BEING POSITIVE I NEVER GET ILL OR HAVE SYMPTOMS, I DO TAKE ALCOHOL MY QUESTION IS HOW LONG IS IT GOING TO TAKE TO INCREASE MY DC4 COUNT?
THANK YOU
Hi Lebo.
A change in CD4 count from 406 to 394 is nothing to worry about. This is because CD4’s can and do fluctuate. When you say your viral load has increased, what is it now? Have you been adhering to your medication?