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.
True love your cd4 of 5.7 is another way of expressing a value of 570 .
Hi True love,
Sorry, it’s not clear what 5.7 means. What’s your viral load result? And are you taking HIV meds?
Hi I checked my cd4 count says 5.7
Hi Dolly,
Its common to feel this way when a CD4 drops. However its important to know and to understand that CD4 counts, can and do fluctuate. Please see here: http://i-base.info/qa/424
If your viral load were still high, this would be something to be concerned about. However, its not, its dropping and dropping really well. You’re close to being undetectable. When someone is positive this is what’s really important. Your HIV is under control. This is something to be really proud of.
If you were to stop treatment, (which no one would advice you to do) your viral load would rebound. Your HIV would no longer be in control and your CD4 would drop, rather than fluctuate.
Hi
I recently found out I am HIV positive and my CD4 count was 417 and viral load was 34 000and it’s been six weeks since I started with treatment.
However I am worried because my followe up results are showing that my CD4 has decreased to 384 even though my viral load had decreased to 115.
My doctor tells me not to worry about this it’s normal however I cannot help bu be worried because the T-cells that are meant to fight off infections in my body are decreasing which to me translates to Danger.
Help me understand what is the point of me having a low viral load if my T-cells important disease fighting cells are decreasing?
I am even thinking of stopping treatment
Hi Bennet,
Though a CD4 of 124 is low, people can be diagnosed with CD4’s that are in single figures. As long as you’re on medication, which you will be soon, this will rise.
AIDS isn’t really a term that commonly used any more, its more like HIV.
As you’re due to start meds, you may find this helpful:
http://i-base.info/guides/starting
My CD4 count is 124.
I have been recently diagnosed with HIV.
So far, im living well, maintained a weight of 65 kilos, and very active lifestyle.
My CD4 count was conducted 9:00AM.
I will start taking ARV next week, as prescribed by my doctor. Ive been reading websites that says CD4 count below 5hundred already progresses to AIDS? is this true? I just forgot to ask more of my CD4 count and its analysis, but Ill just call my Doc too to validate. Bdw, im asking this because Im just in doubt that my Doc is just making me feel better, and that she told me that this is low, but not that super duper serious that i may go to higher level of ARV.
Hi John C, As Charlotte says above, CD4 can fluctuate. But a CD4 count of 11 is very low. The aim of ARVs is to get viral load to undetectable. And being undetectable is the way to help your CD4 count recover. Can you ask the clinic for your viral load result? If it is not below 50 copies it can mean that the ARVs you are taking are not working. If that’s the case you can ask the doctor to find out why, and talk about switching ARVs. It’s important to talk to your doctor about this soon.
my cd4 start at 38 after 1yr took ARV my cd4 count going down at 11… did the medicine effect with me
Hi Chrisy,
As your viral load is undetectable, this means that the meds are working and working really well.
Even when some people are on medication it’s very possible that their CD4 count may not rise very much, this is particularly the case if someone starts medication with a low CD4 count. Its not possible to say why this happens.
You’re already doing the best thing for your HIV by being on meds.