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 Lesego, thanks for talking about your experiences. Some people are lucky and have a stong immune response to HIV. It is still good that you are on treatment now though. It is really good to hear you are doing so well.
I got infected with HIV virus in 2004 by my first boyfriend and only boyfriend who later admitted to me. In 2006 I finally tested and I was positive my CD4 was 550, I started taking multivitamin called MN7. 2015 my CD4 went as high as 900 then on my next check went down to 600 and my VL was 3000 so I decided to start with ARVs (Trivenz) this year March. My new DR was surprised that even after 10 years I am still not sick and don’t necessary need ARV.
It’s very important that you get your rash looked at by the doctor. Many people get side effects when they first start taking ARVs. But these are normally mild and go away soon. Sometimes a rash can be more serious, the doctor and clinic can help find out what’s causing it.
Unfortunately, to treat HIV you need to take ARVs, so you can’t rely on healthy eating and exercise alone. Healthy living can help your ARVs to work properly to keep your CD4 count strong.
You can find out more about starting treatment and side effects here
http://i-base.info/guides/starting/what-about-side-effects
Hi, last time I checked my CD4 was 416, this is my first time of getting a CD4 count since I’ve known that I’m positive last May 2016. I am on 1 week of lamivudine and zidovudineand efaverinz, but i am starting to have rashes all over my body?? Can I stop ARV and rely on healthy living? ( healthy eating, exercise, etc..) im afraid of side effects in the future.
If you’re not on HIV treatment (ART) then HIV can reduce your CD4 count to 81 and lower. But 81 is not a guide to how long the virus has been in your body. Having a CD4 count of 81 is quite low, and it can mean that you are at risk of getting other infections.
Taking HIV meds (ARVs) can help get HIV to undetectable levels, and this can help your CD4 count to go up and keep you healthy.
You can find out more about ART and CD4 counts in the i-Base guide:
http://i-base.info/guides/starting
When your CD4 count is 81 does it tell you how long the virus has been in your body?
Trixazole contains two antibiotics. There are many reasons why you might need to take this and you should ask your doctor about it.
If you’re HIV positive and have a low CD4 count these antibiotics can protect against many infections.
When a person is HIV positive and is on ARV treatment, when does she or he stop taking Trixazole?
It’s important to find out why you’re losing weight. You don’t say what your viral load is. But an undetectable viral load means the meds are working.
You can talk to the clinic and ask them to find out about your weight loss. There can be reasons why you’re losing weight that are not related to HIV.
I’m HIV positive. I gave birth last year on the 6th of December. My CD4 count is 350 and I’m on meds. But my worry is I’m losing weight.