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 Siza,
Its very possible that one person can be positive and another negative even when they’ve been having sex without a condom. And if they weren’t on treatment. For a detailed answer please see Q5 here:
http://i-base.info/qa/what-are-the-most-asked-questions
With regards to seeing your children grow up, there’s no reason why this won’t happen. You’re on treatment, your CD4 is great and your viral load is undetectable. This is all amazing stuff. Therefore, your life expectancy should be how it was prior to contracting HIV.
Because you’re pregnant you may find our HIV and pregnancy guide helpful:
http://i-base.info/guides/pregnancy
It may also help to know that because you’re undetectable the risk of transmission is close to zero. For more info, please see the results of the PARTNER study:
http://i-base.info/qa-on-the-partner-study/
I am 34 married and pregnant,i did an hiv test it says my viral load is lower than detected my cd4 count is 712 and have started the treatment immadiately,hubby is hiv negative since 2014 we test his results will comeback negative but mine positive what does this mean i am stressed i want to llive long to raise my kids.
Hi Asa,
How are you coping with your diagnoses? Are you able to get any support?
CD4 and VL test can’t tell you when you were infected. What you’ll need to do is think about possible risks that you may have taken. This may help you know when you became HIV positive.
Hi my CD4 is 560 and my vl is 3350. I’ve just found out last week that am HIV positive. Can my results tell me if I’ve had it a long time?
Hi Sunet,
A viral load of 120 is great, this does not mean that you have AIDS. If it were your CD4, then this would be a cause for concern.
If my Viral Load is 120 do i have Aids.Please help me thank u.I need some advice please.Is it a good sign if my Viral Load is 120.
Hi Grace,
The World Health Organisation recommend that everyone who is positive should be on ARVs. This is even if your CD4 count is 408. For why its seen as important, please see the results of the START study:
http://i-base.info/i-base-qa-on-the-start-study-results/
Its common that people are scared to take meds, you’re not alone here. However, meds are the only thing that can help your HIV. If you don’t take them, then eventually your health will be compromised.
Our, ‘Introduction to ART’ explains why ARVs are so important, as well as what to expect.
http://i-base.info/guides/starting
Hi ! I’m HIV positive and not on treatment. I’m 25 and my CD4 is 408. Am I in a bad position? I’m really scared to take the medication, I can’t imagine taking them for the rest of my life.
Hi Amanda,
If you’re on meds and undetectable, then the risk is close to zero. Please see the results of the PARTNER study for more info:
http://i-base.info/qa-on-the-partner-study/
I am HIV positive with a CD4 count of 230, I’m on ARV’s. I’m married but we don’t use protection. Will my hubby get infected?