Question

Is a CD4 count under 100 bad?

7 January 2016. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.

I am a 25 year old male and just found out i am HIV positive.

Ihave a CD4 of 41 and a viral load of 3,500,000 copies/mL. I am told I need to start treatment.

What dose my CD4 and viral load mean? Is it bad? I’m feel really worried and scared.

Thank you all very much for your help.

Answer

Answer: Simon Collins

Hi

I’m sorry to hear you are having a rough time.

It is never easy to find out your are positive. It is going to take time to get used to this and to learn about how this will affect your life, but it will get easier.

Your CD4 count is a measure of your immune system. to HIV

Your doctor is giving you good advice about the need to start HIV treatment (ART).

Your immune system is currently very vulnerable to infections – so the sooner you start ART the better.

Hopefully you may have already started by now, or are planning to start this week.

Because your CD4 count is below 50 you should also have an eye exam (for CMV). Until your CD4 count gets over 200 (and it will on treatment) you will also need to take an extra antibiotic medicine called Septrin to reduce the risk of other infections.

Your viral load is also very high. This might mean it is important to use an integrase inhibitor when your start. This will help bring viral load more quickly than other HIV drugs.

One caution to the advice above is if you are in very early infection. Most people with your results would be expected to have been HIV positive for many years and you have just been diagnosed late.

Sometimes people who were definitely HIV negative a year earlier who have a bad reaction to a very recent HIV infection. Even when this is the case, your results would still mean immediate treatment is recommended.

Once on ART your viral load should drop dramatically. Your CD4 count will slowly increase. So this is good reason not to worry or to be scared.

See the Introduction to ART guide linked from this page.

https://i-base.info/guides/

We can post you a copy if your clinic has not already given you this.

Also if you’d like to talk through any of this please call the phoneline on the number below in the signature.

Direct links to pages with information about CD4 and viral load are:
https://i-base.info/guides/starting/two-essential-blood-tests
and
https://i-base.info/guides/starting/how-does-cd4-count-relate-to-the-risk-of-becoming-ill

This answer was updated in January 2016 from a question first posted on 21 November 2011.