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Question

Do I have AIDS if my CD4 count is below 200?

Hi, I have recently been diagnosed with HIV and my CD4 count is 114. Does this mean I have AIDS? because that’s what the internet is saying if it’s less than 200.

Answer

Hi, how are you doing?

No. You do not have AIDS. A CD4 count below 200 is considered part of AIDS, but alone it is not appropriate to diagnose AIDS. A secondary complication (often an infection) would be required for this diagnosis.

AIDS is also much less commonly used now. As with treatment, CD4 counts can increase, AIDS is reversible and as such this diagnosis is no longer used.

Are you on any treatment? When you have a CD4 count below 200, patients are often given their HIV treatment and an antibiotic called co-trimoxazole. This is a treatment used to prevent other infections as your CD4 count recovers.

CD4 recovery can be a slow process. It does not respond in the same way as viral load. HIV treatment prevents HIV breaking down CD4 cells. The body then naturally recovers these cells. Being adherent to medication means your CD4 count will soon be above 200.

Josh.

6 comments

  1. Christina Antoniadi

    Hello Jamie and thanks for getting in touch.

    Were these results before starting Biktarvy or after?

    If these are the results before starting Biktarvy then at your next tests you should expect to be undetectable.

    If these are the results while taking Biktarvy then your doctor should review and discuss steps forward

    It is very important to avoid taking supplements at the same time as Biktarvy cause they interact and prevent its’ absorption.

    You will need to space any supplements by 6 hours at least.

    Also, you can try taking biktarvy with food as it absorbs better.

    Apologies if I am not answering your question – please clarify what other information you might be looking for

  2. Jamie

    I have a viral load of 478,000 and a cd4 count of 194 I’m on biktarvy now for 3 months what do I need to be ready for on my next lab test

  3. Simon Collins

    Hi Paul, thanks for posting. Even though HIV meds usually increase CD4 count to higher levels, a small percentage of people do have this response. This isn’t a reason to explain this and so far these also isn’t a treatment that can increase CD4 counts directly. This small US study is looking at whether an HIV drug called fostemsavir might help,
    https://clinicaltrials.gov/study/NCT05220358

    This is something to discuss with your doctor if the results turn out to be positive.

    It is really good that you are on treatment and that your viral load is undetectable. This shows that the meds are keeping HIV down to such low levels that you will be protected from most HIV-related complications, even though your CD4 count is still low.

  4. Paul

    I have HIV but my cd4 count is 186 but I have no viral load, I don’t understand these results as I have and had it for 24 years it goes up and down. Are the meds working?

  5. Josh Peasegood
  6. Fortress

    I am so scared of going for the test

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