Question
My CD4 is 500, VL is 1000, is that bad?
21 January 2013. Related: All topics, CD4 and viral load.
My CD4 is 500 and viral load 1000, should I be worried?
Answer
Hello,
Thank-you for your email. Can I ask if you have just been diagnosed with HIV? If you have, how are you coping?
Both of your test results are very good.
A ‘normal’ CD4 count for somebody who is HIV negative is between 400-600. In the UK HIV treatment isn’t recommended until your CD4 count is 350 or below. This is because while your CD4 count is above 350 your immune system is still strong, and you are very unlikely to become ill because of HIV.
Your viral load is quite low, which is good. The viral load isn’t such an important test result unless you are on treatment already.If you are not on treatment then the viral load result is not usually used to make any treatment decisions. The exception would be if your viral load was 100,000 or above, which can be a reason to start treatment.
If you are on treatment the aim is to reach a viral load of less than 50. This is usually achieved within 3-6 months of starting treatment.
For more information about CD4 count and viral load please see our Introduction to combination therapy.
Hi Robert, Avonza is a version of Atripla, but unlike most manufactured versions of Atripla, Avonza uses lamivudine instead of emtricitabine. Are you aware of any reason that you may have been put on this specific combination?
If there is no reason as mentioned by doctors or your previous health may suggest, any generic version of Atripla would suitable. This combination would be most like the combination you have been taking for the last 3 years. Atripla: https://i-base.info/guides/1561
Another combination to consider is TLD. Many people are being switched from efavirenz based combinations like Atripla for dolutegravir based like TLD. This is due to them both working as well as each other but TLD being generally better tolerated.
Something else to consider is Spains healthcare system and how they approach management of HIV. There may be further combinations that are more suitable and for which you will gain access to. As i-base is a UK based charity I am unsure of the details. Have you made contact with any HIV charities based in Spain or the area for which you will be going?
Hi, im using 3 years Avonza 300/300/400mg now. Issued in Asia but in Spain it’s not available. Which alternative can u suggest to replace it? My VL was already undetectable from apr 2019 and my cd4 was 534 when i started medication in sept 2018.
Hi J, no you could not pass on HIV at this time. Viral load needs to be greater than 200 to be possible to transmit HIV to sexual partners. Did you have a second test after this result? As you were undetectable before and after this result of 156 it is more likely to be a blip: https://i-base.info/guides/changing/blips As you have mentioned, it is possible that the presence of other infections at the time of testing temporarily increased your viral load.
Hi, I’ve been undetectable for 5 years but last year my viral load went to 56 then 6 months later it was 156 and now its back to undetectable.
My question is, during the time where my viral load was at 156 could I have transmitted hiv?
Also what if there was herpes or other stis involved during that time
Hi Pakiso,
How long have you been taking ARVs for? What is your viral load history?
If the medication that you’re using isn’t working, you’ll need to change to another combination. Please see here: https://i-base.info/guides/changing
If your meds are no longer working it’s important that you change your combination ASAP. With the right combination your viral load should be undetectable before you give birth. It is however important that your viral load is monitored.
There’s more info here about pregnancy: https://i-base.info/guides/pregnancy
Hi I’m stressed because I am pregnant with a viral load of 13000 and I’m taking medication. My stress is that I’m 27 weeks pregnant and worried my load will not drop by the 40th week. There was a week I fell sick, before I found out I was expecting and was not consistent with my meds but the doctor said it means the medication is not working cos my load is not decreasing. Is it useless to continue with meds or continuing will help me save the baby.
Hi Lizzie,
If you’re taking medication, how long have you been taking it for? Has your viral load been lower than 600 copies ml?
Im worried my viral load is 600 is it safe
Hi Patu,
Please can you tell us more? What HIV meds are you taking? And have you been taking them for long?
And if you have access to your CD4 count and viral load results, please tell us what they are.
Please see this link to HIV treatment (ART) in Pictures. It shows what happens to our viral load and CD4 count when we start ART.
If you’ve been on ART for while please check with your doctor that your HIV meds are working as well as they should.
Am worried my viral load is 1500, am i safe