Question
Please can you answer these three questions about CD4 count?
9 October 2013. Related: All topics, CD4 and viral load.
Please can you give me advice about these three situations?
Situation 1: I am last two years positive. age 33 man. i am not on medicine. my cd4 1515. viral load undetectable.
No smoking no drinking. Eat well. Can I live long?
Situation 2: I am fit and hiv+ my last cd4- 1200. no viral load. I am not on meds because i am afraid about ARVs.
what can i do? what is the right time to start ARVs? can I use a healthy diet to improve my CD4 count without using ARVs for 15-20 years?
Situation 3: My CD4 660 viral load 400. i am not on med. if my CD4 is over 500, does that mean i am normal as HIV negative person? I am slim so what can do to increase my weight?
Answer
Hi,
Thanks for your emails. Please see our Introduction to combination therapy for general information about CD4 counts, viral loads and starting treatment.
Situation 1
A CD4 count of 1515 is high but still in the normal range. The ‘normal’ range for HIV negative people is 400-1600, so you are right at the top of this. This suggests that your immune system has not been damaged by HIV. It is very unusual to have an undetectable viral load when you are not on treatment. A very small number of people do have this, but it’s important to check with your doctor if this is correct.
If these test results are correct this means you are doing very well. You will need to be monitored regularly by a doctor. If your CD4 count drops you may need to start treatment with ARVs. In the UK people usually start treatment when thier CD4 coiunt is between 350 and 500. So long as you start treatment if/when you need it your life expectancy almost the same as an HIV negative person.
Situation 2
When you say you have ‘no viral load’ do you mean that you have been told this is undetectable, or that you do not have access to viral load testing?
A CD4 count of 1200 is very good. In most countries people don’t start ARVs until their CD4 count is below either 500 or 350.
Almost everybody needs treatment at some point but the time it takes between infection and your CD4 count dropping to 350 varies a lot between people. Please see this page about average time to treatment.
No foods, supplements or herbs can increase your CD4 count. ARVs are the only medicines that can do this. Eating a healthy diet may help to maintain your CD4 count for longer though and is good for your health generally.
Situation 3
Are you HIV positive? I have assumed that you are in answering this question, although you as if you are normal ‘as HIV negative person’.
A CD4 count of 660 is very good, and a viral load of 400 is also good. This shows that your immune system is still strong. Please see this page for information about CD4 counts and risk of illness.
If you want to gain weight you will need to increase the number of calories you eat. If you are worried that your weight is too low and you can not gain weight it’s important to discuss this with your doctor.
Hi,
It looks like you are doing really well on treatment. Having an undetectable viral load is the main aim of HIV treatment. Your CD4 count is also very strong. It is well above the level where you would have to be worried about HIV related infections.
You can find more information about CD4 and viral load here:
http://i-base.info/guides/starting/cd4-count-and-viral-load
I just had my viral load test that read undetectable and CD4 count is 512.please am am I doing fine.i need your response.thanks
Hi,
it is great that you are thinking about having a baby. Many couples like yours, where one partner is positive and the other is not have children now.
This is normally done using treatment. You should tell your doctor or clinic about wanting to get pregnant. They can give you information about how to do this without infecting your partner.
You can find more information here:
http://i-base.info/guides/pregnancy/what-to-do-when-one-partner-is-hiv-positive-and-the-other-is-hiv-negative
Hi i’m 28 years of age I am HIV+ and my parter is not. How can we have a baby without me having to infect him?
Hi Olumde
Not all countries have viral load tests. If they are not available, then having a good CD4 count is the next best thing. Your CD4 count is doing really well, so it sounds like your meds are still working well.
If you don’t have viral load terse, it is even more important to be careful with your meds and not miss or be late with doses.
Please I need your prompt response.I am hiv+ and I have been on Arv for 3months,and I dont have access to do a viral load but I did the cd4 count.and the result is 616.can you tell how good is this since I dont have my viral load test
Hi Peter, as your comment deals with a new subject to the original question, I have posted this as a new answer here:
http://i-base.info/qa/10164
I am gay and my partner is HIV positive, with an ‘undetectable’ viral load, on treatment. We have unprotected sex as I was told the risks involved are minimal or almost none according to recent trials. He restarted smoking and I am concerned whether this might increase the risk of me becoming infected. Am I right of being concerned? Thank you!
Hi Sizakele, please have a look at this page in our pregnancy guide and then let me know if you have any questions.
Hi I’m a lady of 25 and I am hiv+ and my partner is hiv- so we want a child,can you suggest an easy way to do it without infecting him an the baby aand how high must my CD4 be please help.Thank you