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 Theodor,
The World Health Organisation recommend that everyone who is positive should be on treatment. This includes people who have high CD4’s. Therefore, if you feel ready then you should start treatment.
My CD4 is just below 500, should I start treatment?
Hi Obed.
A persons bloody type is of no relevance when someone is infected with HIV. Neither will their blood type influence testing for HIV.
For testing info, please see Q1 here:
http://i-base.info/qa/what-are-the-most-asked-questions
How does blood group (0+)do when its infected with HIV?Does the doctor find the virus after five months of contraction?
Hi Zazo,
A persons CD4 count doesn’t influence if they will transmit HIV or not, it’s a persons viral load. If you aren’t on treatment and your viral load is detectable, then yes there is a risk that your boyfriend will have contracted HIV.
If, however you’re on medication and your viral load is undetectable the risk 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 had sex with my boyfriend several times, my CD4 count is 700, will he get infected?
Hi Khalanga,
With meds your mothers CD4 will go up. It may however take some time to reach normal levels because she started meds at 150. Other than meds because your mothers CD4 is 150 she should also be taking co-trixmoxazole. Is she taking this?
My mum’s CD4 count was below 150. Now she is taking ARVs. She’s 55. Will her CD4 count go up and become normal again?
Hi Nana,
Firstly when you’re pregnant and have HIV, the test result that’s of most importance is your viral load. This is because the level of your viral load will influence if you can have a v birth or not. Because yours is undetectable this means that you can have a v birth. That is as long as their aren’t any complications during labor.
Being undetectable also reduces the risk of transmission to your baby.
CD4s can and do fluctuate. Therefore, this is something that you don’t really need to worry about. This is because your viral load is undetectable. And also, because yours is still high. For more info please see here:
http://i-base.info/qa/424
Because you’re pregnant you may also find our HIV and pregnancy guide helpful:
http://i-base.info/guides/pregnancy
Am 36 week pregnant and on medication.My CD4 count was 800 at 8 weeks, I’m on Atripla. I changed to Truvada and another med. At 36 week my CD4 was 670 what could be the cause of the drop? Both times my viral load was undetectable. Can I still have a normal v.birth?
Thanks in advance