Question
Does a viral load of 23,000 and CD4 17% mean my son is getting sick?
8 May 2012. Related: All topics, CD4 and viral load.
My son was born with HIV. He is 25 years old. His last viral load was 23,000 and CD4 was 17% does this mean he is getting sick?
Answer
CD4 counts are used to measure how HIV is affecting the immune system. A ‘normal’ CD4 count for somebody without HIV is around 500. CD4 counts are one of the tools used to help decide when to start treatment. But because CD4 counts fluctuate widely another measure – the CD4 percentage- is used as a more stable measure of changes in the immune system. Please follow this link for more information about CD4 counts and CD4 percentage.
Can I ask if your son is currently on treatment? A CD4% of 17% suggests that his CD4 count is around 250. In the USA treatment is recommended for anybody with a CD4 under 500. What advice has your doctor given?
A CD4 count of less than 350 means that you are more at risk of developing opportunistic infections. This doesn’t mean that your son will definitely get sick, just that it is more likely. Please follow this link for more information about CD4 counts and the risk of becoming ill
Hi Sipho,
CD4 counts come in whole numbers, so for example 300. What is yours? Has your viral load even gone below 50?
i.ve been taking ARV’s for 2 years now. but last month i found my result like viral load is 61 cd4 count is 1.79 actually i don’t understand what does that means please help me? and viral load they didn’t write in full numbers
Hi Sipho,
CD4’s come in full numbers not for example 1.79. Could you please confirm your CD4 and also let us know if you’re on ARVs.
what if my viral load is 61 and cd4 count is 1.79
Hi K Kumar,
Now that you’re on medication, your CD4 count will rise and your viral load will decrease. If your viral load was 2536 prior to starting meds, its now very likely that it will be much less.
Sir my cd4 is 336. Viral load 2536. Started treatment 3 weeks ago
Hi Erik,
There’s no need to apologise, your questions aren’t silly and are very common concerns for positive people.
There is a wide variability of CD4% even with the same CD4 count. So two people with a CD4 of 500 could have a CD4% of 32% and 20% or wider. This would only cause your doctor concern if there was a big change in CD4% or if it was below around 15%. Generally the CD4 percentage is used to indicate a change in the immune system so the stability between your two test results is a positive sign that your immune system is still strong.
As for an increased risk of catching colds and other viruses it’s very unlikely that this is linked to your HIV. Because your CD4 count is high you’re not at an increased risk of other infections. It’s very normal for somebody who is recently diagnosed to assign any symptom of illness to HIV but the reality is there is unlikely to be any connection.
Best wishes
Dear Rebecca,
Thank you very much for your response.
So what you’re saying is that even though “a CD4% of 29% is about the same as a count of over 500”, me having a CD4% of 24% can still be equal to 500? And even though a ‘normal’ person hast a CD4% of 40%, I still have a “strong” immune system with 24%?
Also, I wanted to know if the likelihood of me getting recurring upper respiratory tract infections (ie. sore throat, blocked nose) increases when my immune system is around the levels mine currently is?
I ask this because since I found out about my status 4 months ago I started getting this mild yet annoying symptoms on an continuous basis! I wonder whether there’s a correlation between me finding out I am positive, therefore triggering a psychological proclivity to me getting sick, or if it is a fact that having HIV increases the likelihood of having common colds all the time….?
Sorry for the elaborated and potentially silly questions.
You’ve been very helpful
Hello,
Thank-you for your question.
Your CD4 percentage is the percentage of white blood cells that are CD4 cells. The CD4% looks at the CD4 count in relation to other immune cells. The CD4% is sometimes a more stable indication of whether there has been a change in the immune system. An unexpected drop in CD4 count when the percentage hasn’t changed indicates that this drop is not clinically significant.
CD4 percentages vary between people, and there is a wider range of variability at higher CD4 values. There isn’t a discordance between your CD4 and CD4%. You should feel confident that the stability of your CD4% shows that your immune system is staying strong. Please take a look at this link if you’d like to read more about CD4 count and CD4%.
I currently have a CD4 count of 500 and CD% of 24%, 3 months ago I had a CD4 count of 650 and CD% of 25%. Is there a discordance between my CD4 count and CD4%?
Since you say 17% is around CD4 count of 250 then that would mean that 24% is around CD4 count of 350, but I am much higher than that.
Should I be concerned? Why is my CD% lower than expected? I am not on treatment and VL has always been <4000.
Thank you