Question

Why is my CD4 count only 79 yet I'm newly diagnosed?

4 July 2012. Related: All topics, Newly diagnosed, Starting treatment.

I think I was infected 3 months ago (March 2012) but I don’t know for sure. My last negative test was Aug 09. My first CD4 count came in at a shocking 79! I was expecting at least 500 and many months or years to think about going on meds. Could this be just an extreme initial drop in primary stage and my CD count will bounce back up to the asymptomatic stage?
How common is such a sever drop? Does this mean an already severely damage immune system like I was a late diagnosis?
I’m already on prophylactic antibiotics and seeing my doctor next week to discuss results and treatment but I’m very shocked and worried.

Answer

Answer: Angelina Namiba

I am sorry about your recent diagnosis.  I can appreciate your shock and worry.  And especially as you were expecting a much higher CD4 count. The news will take a while to sink in. However, it will get easier with time. How are you coping? Has your doctor put you in contact with groups of people living with HIV? Many find it helps to share experiences of coping with a new diagnosis.

I can appreciate too that it can’t be easy having to deal with starting treatment. And so soon after your diagnosis. A CD4 count of 79 is quite low. It also indicates that your immune system is quite weak. You are therefore very lucky to have been diagnosed before you got ill. The good news is that, once you start treatment, you will start to see an increase in your CD4 count. And your immune system will get stronger. This may take a while. Don’t worry if this is the case, as it is not uncommon. And in response to your first question, some people can reach a CD4 count of 500 even when they start treatment at less than 200.

Please follow this link to our guide, which explains in more detail the average increase in CD4 count once you start treatment.

You also asked how your CD4 count can be so low not long after  your last negative result. There are a number of possible reasons that could explain this. Although this is rare, one reason could be that the result you got in 2009 was incorrect.  A second reason could be that you belong to a group of people known as rapid progressors.  About 5% of people diagnosed take 1-2 years before they need to start treatment. Most people take about 5-8 years and about 15% are slow progressors and can take up to 15 years before they need to start.

As you are preparing to start treatment, you may find it useful to read our guide to An introduction to combination therapy.

You may also find it helpful to contact the Canadian AIDS society. They will be able to put you in contact with  support groups in your area.

Best wishes.