Question
Why has my CD4 count dropped?
18 September 2013. Related: All topics, CD4 and viral load.
My CD4 count was 300 in Nov 2012, that was when I started ARVs.
I found out I was HIV+ in Sep 2012.
My CD4 count dropped to 270 in Aug 2013. I take my meds regularly. Is it common for CD4 counts to drop and what can I do to make it better?
Answer
Hello,
Thanks for your email.
CD4 counts fluctuate. They go up and down. For example, CD4 counts are lower when you first wake up and higher later in the day. There is not a big difference between a result of 270 and 300.
Do you get your viral load checked at the clinic? When you are on treatment checking your viral load is a good way to know whether treatment is working well or not. If your CD4 count is not increasing, or it is going down, it’s important to know whether your treatment is working properly. A viral load test will be able to check this. If treatment is working well your viral load should be less than 50.
If you don’t have access to viral load tests it is important to keep checking your CD4 count regularly. If it does continue to decrease you may need to change treatment because this could be a sign that you have some drug resistance.
Hi Tony,
We are not doctors at i-Base so it’s important that you talk to your doctor about cancer as soon as you can.
CD4 counts go up and down, often in a single day. But to get a better idea of your immune function you can ask for your CD4 percentage. There’s more info about CD4% here.
However, on average, the normal CD4 range for an HIV negative person is between 460 and 1600.
My CD4 was 530 in April , now 481 !! Also I have some worrying cancer markers . Any connection ?
I am on Stribild ( since beginning . Dec 2016) and have more and more itchy spots, aching in hands and knees and numb foot when walking !!
Dear Faith,
This sounds like very poor care. But you can contact Treatment Action Campaign (TAC) and ask if there is another clinic near you. Or you can ask if TAC can offer you support at this clinic.
Hi, my problem is, each and every time when i go to the clinic they don’t check you.. They will ask you the weight nothing else.. I’m talking about a clinic in Cape Town. .. Thank you. I’m Faith
Hi,
Once people who have HIV start treatment their viral loads usually fall quickly. Yours is not particularly high for someone that has not started treatment yet.
The aim of treatment is to reach ‘undetectable’ levels of viral load. ‘Undetectable’ refers to under 50 because this is the lowest that most viral load tests can measure. If you’re on treatment your viral load should drop, if you’re not on treatment it will go up until you start.
You can find more information about viral load testing here:
http://i-base.info/guides/starting/cd4-count-and-viral-load
Is the treatment going to help me because my viral load is 8345.
Hi,
There is no reason that you should terminate your pregnancy if you do not want to. It is common now for HIV positive mothers to have HIV negative children. It is great that you have started treatment. As well as helping you get better it will also help make sure your baby does not become HIV positive. The most important thing to do is to have an undetectable viral load by the time you give birth. A viral load of 28 is very low already and should drop quickly now that you are on treatment.
You can find more information about HIV and pregnancy here:
http://i-base.info/guides/pregnancy
Hi Doctor I found out that am hiv positive in February and I started my treatment (Odimune) in April and my CD4 count was 165 and viral load 28, next month (July) i’m going to the clinic again for Bloods. I just found out that i am 2 weeks pregnant what must I do? Should I terminate or stop my pregnancy or what am confused…
Hi Mpho,
Yes treatment is very effective even at low CD4 counts- even as low as 0. Have a look at this previous question for more information.
can the arv’s help somemne’s cd4 count to go up even when it has dropped to zero(0)