Question
My CD4 is 347… do I need to start treatment?
5 December 2009. Related: All topics, CD4 and viral load, Starting treatment.
Hi there
I’d just like to first say this website has been really helpful.
I was recently diagnosed a few weeks ago: my first CD4 count was 312 and viral load was 1500, which I gather is reasonably low. My second CD4 count as of last week was 347.
I’m meeting my doctor to discuss starting medication as my CD4 count is less than 350. But what I don’t understand is, how can my viral count be so low too? I thought it tended to be CD4 low/high viral load, and vice versa. Surely my viral load should be higher, or does this indicate I have been carrying HIV for quite some time?
I ask because I am a bit upset that I will have to start medication so soon after initial diagnosis, as I thought perhaps I’d have a few years before starting treatment (obviously would rather start treatment if it is recommended!).
Should I hold off another month – has my CD4 count just ‘dipped’ following infection..?
Any thoughts appreciated!
Answer
Thanks for your question and the chance to post the answer online.
There are many good reasons for you to monitor you counts every month for a little longer.
- to see whether any changes are happening.
- if you were only infected recently (within the last 6 months), your CD4 count may increase again by iteslf.
- any risk from not starting treatment immediately are very low
- it will give you time to come to terms with being HIV-positive
- it will give to time to consider treatment options in more detail
- there are no real difference from starting treatment a bit higher or lower than 350
- starting treatment at any level above 300 will still get you to over 500, which which is currently used as a guide for reaching ‘normal’ levels.
The decision of when to start has to be individual, based on your own risks and benefits, and how you feel about changing treatment. As long as you have no other symptoms, your CD4 count is currently strong enough for at least couple of months, not to have any long-term impact on your health.
Although generally low CD4 counts are associated with higher viral load and vice versa, there are many situations where this doesn’t always follow, for different reasons. For example, your current CD4 count is still strong. You could be one of the 5% of people whose natural CD4 count is less than 500 – ie that it would have been under 500 before you caught HIV. In this case, the low viral load indicates not just that you are controlling HIV very well, but that it hasn’t affected your normal CD4 levels.
Hi Andy, as you have not started treatment yet these are common results to be expected. Even with a high viral load, after starting treatment most people will become undetectable within the first couple of months of starting treatment.
Undetectable means that treatment works so well HIV viral load cannot be detected and HIV is no longer impacting your health. It will also mean that you will be unable to pass on HIV to someone else.
Your CD4 count is a little low. A healthy range is between 430 and 1690. When your CD4 count is lower it means that your immune system is not working as well and you are more at risk of other infections. Have you been offered another medication called co-trimoxazole? This is an antibiotic to help prevent other infections while your immune system recovers.
Unlike viral load which responds quickly to treatment, CD4 count recovers slowly. Starting from a CD4 count of 212 it can be expected that it might be a year or two until your CD4 count recovers. This is not something to be discouraged by, instead you need to be patient and adhering to treatment will help to ensure this. How is your health in general?
Starting treatment: https://i-base.info/guides/starting
My cd4 is 212/mm3 and viral load is 1mill copies. Iy makes me worried indeed, but my doctor said dont be worry as i will start my treatment soon. What is your sight about my situation?
Thanks in advance
Hi Kumar, a CD4 count of 374 is below the healthy range. The normal range for a CD4 count is between 430 and 1690. This means that your immune system is a little weaker than normal and you are more at risk of other infections.
Are you on HIV treatment? and if so how long have you been on treatment for? is this the only CD4 count test you have had?
My cd4 count is 374 it is safe or not
Hi Elijah,
The World Health Organisation recommends that everyone who is living with HIV should be on HIV treatment (ART). This is even if they have a high CD4 count. Therefore, if you are ready, then yes, you should begin treatment.
For more info about starting ART please see here:
http://i-base.info/guides/starting
The only thing that can help your HIV is medication. Though a healthy lifestyle and diet are also important.
Hi,i just want to know that CD4 count of 326 is it good to start treatment