Q and A


I am just diagnosed with a CD4 count of 10?

I’ve recently tested HIV+ and unfortunately my CD4 count came out at 10. I am not ill, but do i have the chance to live any longer.



As well as being HIV positive, your CD4 count is very low. Unless you were only infected very recently, this means your HIV is very advanced.

Using ARV treatment (ART) as soon as possible is important. ART will reduce the serious risk of HIV-related health complications.

The medicines will still work for you. There are many reasons to be hopeful and optimistic.

Because your CD4 count is uder 50 there is also a chance that other infections (called IRIS) might become active during the first few months of treatment. These are usuallly easy to treat, but tell your doctor about any new symptoms over the next months.

Also, please be very careful not to miss any doses of your meds. This is called good adherence.

Your doctor should also give you antibiotics to protect you from other infections. This is usually cotrimoxazole (often also called Septrin or Bactrim) which is a combination of  trimethoprim and sulfamethoxazole. This treatment should continue until your CD4 count gets much higher (at least above 200, maybe above 350).

While your CD4 count is still below 50, including now, your doctor should also examine your eyes. This is to check whether a viral infection called CMV is affecting your eyes. CMV can cause serious and permanent vision loss.

For more information see this guide to starting treatment, called Introduction to ART.

If you were not expecting to be HIV positive, this will take a while for the news to sink in. It will get easier – and hopefully you will get a good response from treatment.

These two links might help:

Just diagnosed:

Who can I talk to:

Note: This answer was updated in December 2016 from a question first posted on 13 September 2011.


  1. Lala

    Hi, i recently got my results that im hiv positive and my cd4 count is 95 viral load of 86000 im waiting for my medical aid to approve the chronic medication for my doctor to prescribe for me

    Im scared of the side effect with my sd4 count being so low, I have a red or black spots behing my hands on mu elbows and so on my feet and legs, my eyes turn to be red and i feel floaters inside that i pick out with a zooming mirror, and my back spine is killing me

    What causes all this and will it be more soon I start my treatment?

  2. Lisa Thorley

    Hi Nonoe,

    It’s great to hear that your viral load has dropped down to 90, this is excellent news. You’re doing really well.

    When someone has a CD4 count of less than 350, (in countries in the global south) they are given bactrim. This is given as a preventative measure to ensure that people don’t get infections. If you’ve had some issues with it, please talk to your doctor.

  3. Nonoe


    I was dignosed October last year my viral load was 430000 and my CD4 was 178, after 6 months of treatment viral load drop down to 90. Last week at the clinic they gave me antibiotics called batrim after taking them for a week I started to feel nausea and vomiting then I stopped taking them. My question is what complications will I face if I re-take them.

  4. Lisa Thorley

    Hi Mimo,

    Issues with sleep can be due to a number of reasons. If this is just happening now and you’ll be on meds for 3 months, it’s unlikely to be ARV related. Please consult a doctor.

  5. Mimo

    Hey am taking my medicine from 3 months but from one week ago am sleeping aloot.. am sleeping 6 hours in the night and 6 hours in the day is it normal and how i control this

  6. Lisa Thorley

    Hi Khanyisa,

    If you are having issues with weight loss, please discuss this with a doctor.

  7. Khanyisa

    Hi, I tested no May 2019 and doctor told me that, I am HIV positive. I then started a treatment on June but i forgot what my CD4 Count was at that time. What I remember is that, the doctor told me that my CD4 Count is high so I shouldn’t worry. It was between 300 and 400, but the problem is that since I started taking ARVs. I am losing weight. I would like to know if I use a black seed oil and not stop ARVs, will I gain weight again

  8. Roy Trevelion

    Hi JR,

    I’m sorry to hear you’re so unwell.

    But treating HIV, cancer and candidiasis can be complex. So you need to make sure your doctors work together for your recovery.

    Biktarvy contains bictegravir. This is an integrase inhibitor (INI) and INIs reduce viral load faster than other HIV drugs. Viral load can drop by 90% within the first few days, and 99% in the first few weeks. And this can give your immune system and CD4 count time to recover. Please see this page from ART in pictures that shows what happens when ART is started.

    Good luck with all this treatment, and a speedy recovery to you. Please let us know how you get on.

  9. JR

    I started Biktarvy July 15th with a CD4 of 9 and a week later I was diagnosed with Kaposi’s Sarcoma so I’ll be doing radiation for it soon. It is now September first and my CD4 has only gone up to 15. I will be seeing my doctor in a week and I’m wondering if maybe my medication needs to be changed. I’m also suffering from candidiasis and shingles. I’m so afraid. Is CD3+CD4+ Absolute the same as CD4? That’s what shows on my lab work online.

  10. Roy Trevelion

    Hi Lency,

    I’m sorry to hear you’re so unwell.

    Bactrim is an antibiotic. And it is used to treat other infections, sometimes before starting ART. Please can you tell us more?

    Do you have access to your CD4 count? And do you know what HIV meds you will take, and when you are starting them?


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