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 Angel, The way to boost your immune system is to start HIV treatment (ART). But a CD4 count of 678 is strong.
However, in May 2015, the START study results showed that HIV treatment has important benefits for your health, even if your CD4 count is still high. The study showed that starting ART early was safe and effective. You can find out more about START in this pocket size guide.
Hi guys. I tested early may I was positive my CD4 was 678 the nurse told me I must not start a treatment now because am still strong is that TRUE or NOT? And if its true what can I eat to boost my immune?
Hi, It’s not clear if you tested HIV positive. If you did and you’re now on HIV treatment the rash could be a side effect. It’s important that you call the clinic and tell them about it.
Hi I wanna know I’m HIV positive BT now few days ago I started developing some rush what causes that
Hi Peter,
Testing HIV positive can be tough for most people. If you think there might be a mistake in your result you can go to the clinic and ask for another test to confirm it.
But it’s important to remember that a great many people who are HIV positive are now living healthy lives on HIV medication.
If you still test HIV positive it’s good to know that starting HIV treatment can get your HIV levels down so low that they are undetectable. And being undetectable can dramatically reduce the risk to your fiancé.
Most questions about transmission and testing have been answered here:
http://i-base.info/qa/factsheets/hiv-transmission-and-testing
I was randomly tested HIV positive at work but i am not sure if that results was correct due to the fact that there were so many people that was getting tested on that same day…
Could the doctor perhaps made a mistake and gave me someones else’s results…please help me i am afraid of dying soon.I know i don’t usually have sex because my fience is far away from me…i only do have sex with her when i pay her a visit…please advise.
Hi, It’s good that you’re on medication. This can help get viral load to undetectable. Once that happens your CD4 count will recover.
But usually CD4 counts recover slowly. The ‘normal’ range for HIV negative people is between 400 and 1600. And this figure goes up and down, even during a single day. So even if your CD4 count is 1600, it could be much lower at the next test.
Hi, I’m 32 year old man and my CD4 is below 200 and I’m on medication. My question is that if I go on with my medication can my CD4 go to 1600 as normal?
hi Gugz. Great that you were lucky enough to be able to go for so long without needing ART. Even with such good results it is still probably good that you started ARVs. It sounds better to realax on the gym if you are feeling dizzy. It is better to only exercise when you feel well enough to do this. Most people find this gets much easier within the first few weeks, but if not, talk to your doctors. If you combination includes efavirenz, remember not to take meds with foods that have a lot of fat. This increases drugs levesl and you might get more side effects.
Good day, its my 15th year now living with HIV and my CD4 count has always been 1060 and viral load undetectabke, until the last month when u went for blood count I found out it has dropped to 869 and viral load is 79. I have just started ARV’s 2 days ago, and side effects are nausea and dizziness during the day, what can I use for nausea? Can I continue going to gym or should I wait till my body is used to ARV’s