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.
Good afternoon my viral load is less than 15 copies per ml and the report says not detected.but my cd4 dropped from 499 to 299.which one to take into consideration? I am religiously on medicine since my detection over last date of January.
Hi Suman,
CD4’s can and do fluctuate. However as yours has dropped from 648 to 297 you may be having an issue with your medication. To know for sure if your meds are working you’ll need to have a viral load test done. In India this is possible. Are you able to try another clinic?
On 14 th July my cd4 count came 499 but my cd4 dropped again to 297 on 26th august.i really fail to understand why is it dropping so fast. On 30th january it was 648.that day onwards i stated taking my medicines without skipping a single dose and appropriately on time. However during the last cd4 count on 26 th august i was suffering from dysentery. I cannot understand is there any relation of this dysentery with the cd4 drop ??? I am taking effavirenj lamivudine and tenofovir as prescribed by the physicians. I really feel horrific. Am I going to die soon?? I have not yet gone through viral load test since in india i have to wait a year from the commencement of medicine so it will be done on January 2019.please guide me.
Hi Ankur,
Are your taking HIV meds? Taking HIV Treatment (ART) is the way to help you’re CD4 count to recover. You can talk to your doctor about what vaccines you might need if you’re travelling or going on holiday to places where you might need them.
Hi ,
I have CD4 count of 216 . What vaccines should I take ?
Hi Sushanth.
Is your mother on medication? What’s her CD4 history?
HI
my mother is in very good condition, but her CD4 count is decreased. is there any problem to her?
Hi Suman,
The CD4% can indicate whether this is a real change in CD4 count, or just a fluctuation. The CD4% is generally more stable.
The CD4% is the percentage of white blood cells that are CD4 cells. In an HIV negative adult the average CD4% is about 45%.(But this can range from 24% – 64%).
It looks like there’s no reason to be scared. A percentage of 27% – 29% looks stable and is within the range for an HIV negative adult. There’s more info here.
Suman
Hi I am on arv religiously since past six months of my detection. Initially my cd4 was 648 with a percentage of 27% but recently it has dropped to 499 with percentage 29%.plz guide me. I feel very scared. Am from india and taking med without skipping a single dose.
Hi No worries, Thanks.
Is that right True Love? If so, a CD4 count of 570 is within the normal range for someone who is HIV negative.