Q and A

Question

Is a CD4 count under 100 bad?

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

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.

31 comments

  1. Nelly

    Hi My CD4 is 637 and viral load is LTD7, what does this mean?

  2. Lisa Thorley

    Hi Singh,

    If you’re taking ARVs then you’re already doing the best thing possible. Its being on meds that will improve your CD4 count and allow you to control your HIV.

    If you aren’t on meds then you will need to start them. This is because only meds can increase your CD4 count.

  3. Singh

    How to increase my, CD4 cells
    I’m very nervous
    Please help me

  4. zoe

    hiv no longer killer just follow clinic rules u will be okay

  5. Lisa Thorley

    Hi Priyo,

    Because your CD4 is less than 200 its important that you start ARVs as soon as possible. This is because you may be at more risk of developing opportunist infections. However, its important to realize that many people are diagnosed with much lower CD4’s and they do just fine. You will though need to be on meds.

    For more about what you should be aware of when you have a CD4 of less than 200, please see here:

    http://i-base.info/qa/3560

  6. Priyo

    My first CD4 counts 150, am I in danger?

  7. Roy Trevelion

    Hi, Is this your first medicine because you’re just starting ARVs? It’s important that once you’re are taking ARVs you can access continuing medicine. Is the delay because ARVs are not easy to get where you live.

    Please let me know. Best wishes,
    Roy

  8. Jhameh

    Hi I’m jhameh is not my real name I have a question my CD4 count is 102 so I’m process my treatment for ARV but my process for the treatment is very slow to get may medicine I’m very nervous for late treatment.

  9. Simon Collins

    In order to interpret your CD4 count results, it would help to know more about your history.
    • When you were diagnosed?
    • Are you currently on treatment? If yes, for how long.
    • Is this your first CD4 count? etc

    In general it is better for your CD4 count to be higher.

    If you are not yet on treatment (ART), then starting ART now is important.

    ART will help get your CD4 count to higher levels that are safer.

    Your doctor should also prescribe you antibiotics while your CD4 count is this low.

  10. ugwu

    I was told that my cd count is 91 is it bad

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