Question

Is it normal for CD4 counts to change on ART?

22 August 2024. Related: All topics, CD4 and viral load.

Hi there, I had a decline in my CD4 count that has worried me.

I was diagnosed and started treatment 2.5 years after infection (I’m 22).

My CD4 count was 353 and my viral load 140.000. Two months after starting treatment, I was undetectable, my CD4 went up to 600 and my CD4/CD8 was 0.43.

Now, 7 months after starting treatment my CD4 went down to 343 (CD4/CD8 of 0;76) and I’m still undetectable.

Is it normal to have this big of a decrease?

Answer

Answer: Simon Collins

Hi there

Thanks for posting about your experience and for letting us answer online.

You have done really well on treatment.

It is also good that you are interested in your results and asking these questions.

One you are on HIV meds (called ART) the most important results to for your viral load to be undetectable. This shows that your meds are working really well.

The CD4 count is much less important now, and it is not unusual to have results that go up and down a little. Your changes from 600 to about 400 really don’t mean anything and your doctor will see these as the same.

Less than 2% of your CD4 cells are in blood and things like diet, exercise and recent infections can sometimes cause them to flow more into or out of the blood. This gives yo a different CD4 count but your immune system is still doing well.

For example, your latest CD4:CD8 ratio is 0.76 which is stronger than 0.43 as getting close to or above 1.0 is better.

IF you ask for your CD4 percentage (CD4%) you might find this also shows no real change.

Please don’t worry abot this, but ask your doctor to explain it to if you are worried.