Q and A


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.



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.


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:

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


  1. CJ

    I have been undetectable with HIV since having treatment, now it’s back do I start to worry. It’s count is 237 only just over the 200.


  2. Roy Trevelion

    Hi Swathi,
    Has your hubby started HIV treatment? The way to increase his CD4 count is to take HIV meds (ART). And it’s a good idea for him to talk to the clinic about having tests for infections such as TB too. ART is safe and effective at controlling HIV so that his CD4 count has the chance to recover. You can read more about starting ART in this guide.

  3. Swathi

    Hi I have one doubt about this my hubby hiv +ve. His cd4count count is 94 I want to know how long he is suffering from this. Bcoz he was very healthy men he is fit and fine all off the sudden it happen only from December he suffer from fever waight loss every thing but he under go test on April. It comes +ve cd4count is 94.

  4. Lisa Thorley

    Hi Penwel,

    Its not possible to say how long someone has been positive for from their CD4 count. However, your wife’s is low. She’ll need to be on ARVs.
    If you’re negative, then this would suggest that she was positive possible before you entered into a sexual relationship.

  5. Penwel

    My wife was tested positive and i tested negative ,i have been checking for the past three months but still negative my wife cd4 count result is 64 what does it means because she telling that she never cheat. is it still new or i worse

  6. Lisa Thorley

    Hi Tanky,

    Though ARVs may not in your opinion make people feel better. For millions of others they do. So much so that we’re no different to anyone else. People who are positive and on medication can have amazing very fulfilling lives. Though taking about your status may make you feel worse, for others it really helps.

  7. Tanky

    I’m sorry to say people saying you well feel better if you take your HIV mediaction . that is a load of carp I have never felt better . the HIV mediaction is poison . and you will get more problems with HIV and the mediaction they give us . I will find. A cure for my self . hoping soon 5 years since I found out have been rough for me I can not go to work anymore . talking with someone about just makes it worse for me .

  8. Lisa Thorley

    Hi Christian,

    A CD4 of 341 isn’t too bad. You aren’t ill, your immune system is however compromised. With treatment this will recover.

    Because you’ve just been diagnosed, the following links might help:



  9. christian

    Good day. I was tested HIV + yesterday. 9-28-2017. And my CD4 is 341. And my status is confirmatory.

    My quesyion is: how ill i am then?


  10. Lisa Thorley

    Hi Nelly,

    Viral loads are given in numbers not in letters. Have you been given any more info?


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