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 Angela,
I’m sorry you are not well. But it’s great that you’ve started HIV treatment (ART). Many people have started ART at very low CD4 counts and they recover. But your doctor should have given you antibiotics to protect you from other infections too. This is usually a drug called Septrin or Bactrim and this should continue until your CD4 count is much stronger.
And while your CD4 count is under 50 you should have your eyes looked at to see if a virus called CMV is affecting them.
Being on ART can help increase your CD4 count and help you to get better.
Hi I have just been told my cd4 counts are 3. . I am already sick and receiving treatment Can i still live?
Hi Success,
Sorry we don’t have the resources to answer questions on testing and risk. All frequently asked questions are answered here through this page.
hello plss I need a quick answer on this I tested HIV negative but my cd4 count is as low as 360 plss wat could be the actual cause of this nd wat could be the necessary solution
Hi Johnny,
Even if your CD4 count is 900 you should still be on meds. This is because this is what the World Health Organisations recommendations are. This is mainly due to the START study:
http://i-base.info/start/
I’m been HIV positive since 2013. I went to check just to know my status. I was told my viral load is very high and my CD4 count is 8.im not on medication I just changed my lifestyle. In 2018 I got seriously ill I went for check up of my CD4count so that I can start medication my result come with a CD4count that is above 900 therefore they cannot put me on the program..I’m confused but I’m better now.
Hi Johannah,
A persons viral load will only become undetectable if they are on meds. So if you aren’t on meds, this is something that you’ll need to think about.
For how HIV is transmitted to babies, please see here:
http://i-base.info/guides/pregnancy
When someone has an undetectable viral load they aren’t able to transmit HIV. This is what protects a partner, that or condoms if a persons viral load is detectable.
What makes a viral load undetected where else the person is not taking medication. Howit affect the baby when you a pregnant but it doesn’t affect the partner.
Hi Ntombenhle, A CD4 count is blood test result that shows how strong your immune system is. CD4 cells make up part of your white blood cells. You can read more about CD4 cells and HIV treatment (ART) from the frequently asked questions here.
What does it mean by having 365cdf count and represents as white blood cells