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.
Hi I’m Siya
I started taking tribuss on March 2017 and Cd4 count was 27, however it in June 2017 it had came up to 153 and V/L undetected, fast forwad to July 2018 my Cd4 count was 384 and V/L still undetected, then again now on the 17th of December 2018 went for my bloods test again to my suprise my cd4 count has decreased to 176 and V/L still undetected, I am worried but my doctor said I shouldn’t be worried as long as the HIV is supressed meaning that as long as my V/L is undetected I should be worried, but I can’t help it because I never miss my medication, should I be worried? Please help
Hi Lolo,
I’m sorry to hear your daughter is not well. But treating HIV and TB together can be complex. Can she talk to the doctor about her symptoms? Can you give her some support and see the doctor too?
Talking to the doctor might help find out how long she needs to take the TB treatment. Does she know what her CD4 count and viral load are?
Hi im Lolo my daughter is HIV and defaulted currently talking tb and HIV treatment however there’s no sign of improvement she’s forever tired and sleeps and also got nausea although not taking out what should be the reason and how long will this comes to normal
Hi Anonymous,
I’m not sure what the figures mean. Please can you give us more information that includes what meds you’re taking and if viral load is undetectable.
What does Cd4 G9
AND Cd4 9.33 mean
Hi Namhla,
Have you just started taking ARVs? If so, it’s a good idea to aim for the same time everyday. But an hour difference shouldn’t be a problem if you’re undetectable and you’ve been taking them a long time. What ARVs are you taking, and what is your latest viral load result?
My viral load is not good at all but am taking my arvs everyday but sometimes not same time I suppose to take at nine pm but sometimes I take at ten because of being busy at work.is that the reason why is it not good?because am missing the time?
Hi Beatrice,
How much weight have you lost and over what period of time? Have you had any changes in your lifestyle?
Am on arvs and of late my weight is dropping drastically kindly advise
Hi Suman.
Because your viral load is undetectable this means that your HIV is under control, this is great.
CD4 counts can and do fluctuate as the above post explains.