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 Jennifer,
Unfortunately a CD4 count of 1200 will not stop an HIV negative woman becoming HIV positive. However, if her partner is on HIV treatment (ART) with an undetectable viral load, the risk from HIV is zero.
Please see U=U at this link.
Can a CD4 count of 1200 get a negative woman pregnant without infecting the baby and the woman with HIV
Hi Dave,
It’s good you’re taking ARVs and your viral load is undetectable. Your HIV treatment (ART) looks as though it’s working well.
HIV drugs do not directly increase the CD4 count, but they help make an environment where this can happen. ART enables the CD4 count to increase to higher and safer levels.
In contrast to viral load, CD4 usually increases more slowly and steadily. Reaching a CD4 count above 500 is referred to as normal, but even if it doesn’t reach this high, the risk of HIV-related complications is dramatically reduced.
Please see this page from ART in Pictures.
Hello,
My name is Dave
I am hiv positive. I took ARV since 4 year ago.
Now my virus load is underdetecable, but my CD4 is just 420 for three year.
Please let me know how I can increase my CD4 number
Hi Mary,
Are you on medication? If you are how long have you been on it for?
If you’ve been on medication for more than 3 months, then yes a viral load of 678 would be seen as being high. This is because a persons viral load should ideally be less than 50 within 3 months of starting treatment.
If this is a new diagnoses, then no it isn’t high.
I have cd4counts of 666 and viral load of 678 ,does this mean my viral load is high
Hi Kelvin,
The ‘normal’ range for HIV negative people is 400-1600.
What are the maximum range of cd4 cells to rise?can it rise up to 4000??
Hi Leloh,
Losing interest in sex is more common than you might think for HIV positive people. There are many different factors that can affect your sex drive.
But there’s a lot of info in the guide to quality of life and sexual health.
Talking to your doctor can help. You could ask about whether your meds could have an effect on this. And you can discuss other important things that are going on in your life, these might affect your sex drive too.
Hi I’m HlV positive and I take medicine I drink alcohol sometime.my problem I’m not feeling good when I’m with my partner during sex I don’t feel like doing it what can I do about that please help.