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 Cruz, I have no data to comment – maybe yes if it is related to HIV as other things improve, maybe no if not :)
Thank you Simon for your advise……. one more I have swollen glands behind my ears will they go away when I start taking medication after how long maybe?
Hi Beza, pain behind the ears is not a reorted side effect. It may or may not be related to ART. As with all symptoms this is something to tell your doctor.
hi Simon
im in South Africa thanks for your advise i will give in another set of bloods.
do you have any advise as to what could be causing the throbbing glands behind my ear? does it go away once i get use to meds?
Hi Beza. Sometimes lab results go missing or don’t work properly. It would be good to get these. Because your CD4 count is so high, it would have been okay to wait for them before you started treatment. As you have started, it is good to follow up until you get the result – even if it mens giving another set of bloods. Your doctor is giving you good information about stress rather than HIV causing these symptoms. However, efavirenz could be contributing to your anxiety as a side effect – until your body adjusts to this. Which country are you living in?
Hi
Firstly would like to apologize about the number of questions I have
I tested HIV reactive on the 28August 2016 with my rapid test which followed a lab test that was also reactive.my CD4 is 570 and when going to my doctor 5 days later to try start medication, she’s still struggling to get my viral load results from the lab, she’s also unsure as to why they taking time. When she tries to phones the lab assistant says they not ready. We have however decided to started treatment as I’m worried of being sick and it’s my 2nd day on treatment I take atripla one pill at night
Q1 Should I be worried about the lab not giving info and taking longer then expected with my viral load count or is this normal?
Q2 I’m also having runny tummy but this was prior to me even knowing I’m HIV positive. I’m assuming it was one of the symptoms together with shaky hands/fingers (quite noticeable a lot of the times) is this normal?
Q3 I’m struggling with dry nostrils that have slight blood when I blow my nose and have build up mucus that I have to pull out every morning. Is this also normal?
Q4 I’m forever thirsty since being on medication is this normal
Q5 my partner was non reactive. He said I should go for a second test, but I honestly have lost hope and don’t want to go through more tests again my doctor has said I should accept the result and that it’s unlikely that they are incorrect. I have decided to follow her results. The glands around my ears are throbbing is this a sign of swollen glands that are developing?
I have asked my doctors Q2 & 3 and all she says is that, I shouldn’t be experiencing any symptoms as I’m still healthy, she says it could be my stress levels.
Thank you for your answers
Hi Innocentia
This is something to discuss with your doctor.
Guidelines say that treatment can be stated at any CD4 count, so based on this it is fine to start now.
It qlso depends where you live. Somme countries provide treatment for everyone and still recommend treatment waiting until the CD4 count is a bit lower – for example at 500.
When can i start my treatment im positive and my cd4 count 996
Hi Magnificent
There are two ways to look at your question. Firstly, if your first HIV test was confirmed with a second lab test, then you are still HIV positive. This means that the second HIV test just produced a false result. This is the most likely explanation. All guidelines recommended that an initial HIV test is alwasy confirmed with a second test.
If your HIV test was never confirmed, then it might be important to take a third HIV test and to talk to your doctor about the results.
If you have ever had a viral load test that was positive, this would also confirm the first test was the right result.
If
hi, I tested positive August last year and was put on treatment because I was pregnant now I tested again I TESTED NEGATIVE it it possible?