Question
Can my CD4 count indicate when I was infected?
31 July 2012. Related: All topics, CD4 and viral load, Newly diagnosed.
I have just received my CD4 count which is 23. Can this help me know when I was infected?
Answer
Unfortunately, it is not possible to find out when you were infected using one CD4 test result alone. Single CD4 counts are not a reliable way to find out when someone was infected. This is because a normal CD4 count is different for everybody – with or without HIV.
The normal CD4 count range for CD4 counts without HIV is between 400-1600. A ‘normal’ CD4 count for an HIV-positive person is getting above 500. This is an ideal goal although many people remain well and healthy with CD4 counts that are below this.
In general though, CD4 counts tend to drop over time when someone is not on treatment.Although the rate at which they drop is different for each person. And this makes it even harder to estimate date of infection.
In your case, a CD4 count of 23 would indicate that your immune system is quite weak. The good news is that though, you have been caught in time. It means that you can start taking ARVs (antiretroviral treatment for HIV) to keep you well. Are you able to access ARVs? This is because, the treatment we now have for HIV is extremely effective even for people who start with a CD4 count lower than 10.
Can I ask what your doctor has advised? Can I also ask if you know what your viral load is? This is because, even with a low CD4 count, if you start and follow your treatment carefully, you have a good chance that it will work. Your viral load will drop and your CD4 count will rise to safer levels.
Please follow this link to our guide which details the average CD4 increases by starting treatment.
In addition to ARVs, your doctor should also prescribe Septrin (also known as co-trimoxazole). This is an antibiotic which prevents you from getting illnesses such as pneumonia which can develop when your CD4 count is below 200.
You may find it helpful to read our guide to An introduction to combination therapy. It answers a lot of questions you may have around starting treatment.
It is not very clear from your question if you were recently diagnosed. If you were, then you may also find it helpful to contact other people living with HIV. Many find it useful to share experiences of living with HIV and coping with a new diagnosis.
FOPHAK – The Foundation of People Living with HIV in Kenya can put you in contact with support groups near you.
You can contact them via email on: fophak@yahoo.com or by calling: 00254202724703.
Best wishes.
Hi Mark,
A detailed answer to a similar question can be found here:
http://i-base.info/qa/4842
Hi I was diagnosed with hiv in 2010 is it possible to know when i first got infected. In 2013 my cd4 count was 167. I was put on arv’s (Atripla). My cd 4 count to date (2016) is just over 500.
Hi Julia
If you are HIV meds (ART) then it sounds like the doctor thinks you are HIV positive. Did you ever have a viral load test? Sometimes if the HIV test is unclear the viral load can be used. It might be that the doctor confirmed your HIV test with another test sent to the lab. As this is worrying you, please ask your doctor how your HIV diagnosis was confirmed.
Dear Angelina
I was having abnormal pap smear result and went for LEETZ treatment. Six months later I went for HIV Test my results were equivocal and my CD4 count was 434. I went again to draw up blood then to the lab still result was equivocal; before I decide to go for hysterectomy thy started me on HIV treatment. So I don’t know if I’m positive or negative. Please help
Hi Chris, the average CD4 count for an HIV negative person can be anything from 400 to 1600 – so you are right in the middle.
i tested hiv positive in january I submited my blood for Cd4 in March my cd4 count is 674 and im physically very fit my viral load is 40 isnt my cd4 too high for a hiv positive person especially in the first 3 months of infection
Dear Gikumba
Thank you for updating me on your progress so far. It is really good that you have now started treatment. You seem to have a good relationship with your doctor. Which is great too as it is important to be able to communicate well with him/her. It also helps you to make informed decisions in managing your health-care.
You mentioned that after much deliberation with your doctor you decided to choose the AZT/3TC/NVP instead of the TDF/3TC/NVP. Is there any particular reason why you chose the first option?
In response to your question, both options are fine to start with.Although some people on AZT can experience anaemia, nausea and tiredness. As with any side effects, they affect different people in different ways, and many usually settle down within the first few weeks. Whereas other people don’t experience any side effects at all.
Wishing you all the very best wishes with your treatment and please do not hesitate to contact us again should you have any further questions.
Angelina
Dear Angelina,
I don’t want to personalise this forum but I felt it important to let you know that I started my meds on 3rd Aug, 2012….Today is my second day and am fine so far. After much deliberation with my doctor, we agreed I start with AZT/3TC/NVP instead of TDF/3TC/NVP……What do you think of this choice?
Regards,
Jambo Gikumba
Thank you for your comment. It’s really good that you have managed to move from your initial fear and get some support. Being in denial when you first receive a diagnosis is not uncommon. Many people find it hard to cope with an HIV diagnosis in the beginning but find that things get better with time.
Taking it one day at a time helps. Many also find it helpful to talk to other HIV positive people and finding out how they cope. Your decision to live positively is therefore definitely a good thing.
The other good thing is that, nowadays, the treatment we have for HIV is extremely effective. With access to and good use of HIV treatment people living with HIV can expect to live for many years.
The reason why you haven’t been sick could be due to any number of reasons. This includes the fact that HIV affects individuals differently. Some people need to start treatment within a year or two of being diagnosed, whereas others can stay well for more than 8 years without needing treatment.
It’s good though that you now know your status and that you can look after your health.
Best wishes.
Dear Angelina,
Thank you very much for your detailed response. I have not known my viral load yet. I think I just got terrified with the very low CD4 count. I have however discussed with my doctor and she gave me a week to think on starting ARVs. I got diagonised on 4th July 2012 but was in denial for almost a month. Its only after that that I have taken the necessary steps towards living positively and went for the necessary tests. What surprises my though is that, apart from the shingles, I have not been sick at all and I just wonder how I have been managing.
I will get in touch with FOPHAK and see how it goes.
Regards,