Question
My CD4 has dropped from 900 to 600, should I worry?
20 August 2012. Related: All topics, CD4 and viral load.
Hi. I am Poz and am not on medication. Over the past 4 years, my average CD4 was about 900 but now all of a sudden, it has plunged to about 600 and my VL tripled to 12.000 copies rather than an average of 2500. Should I worry?
Answer
NOTE: This Q&A is out of date because since 2016 everyone is recommended to go on ART, whatever their CD4 count and viral load.
Hello,
Thank-you for your question.
Although these results may have come as a shock it’s important to remember that this is still a very good CD4 count. In most countries treatment guidelines recommend starting treatment when your CD4 count is around 350 or less- you’re still well above this point.
Many things can influence your CD4 count.
These include: other underlying infections, stress, exercise, the menstrual cycle, use of contraceptive pills, time of the day when the blood sample was taken, temporary changes in concentrations of CD4 cells in different body compartments, or just a mistake in the lab, etc.
That is why the trend in CD4 results is more important than a one off reading.
As this is quite a large drop though, you could discuss this with your medical professional and request a second reading both from the same sample and from a new one. Your doctor should also look at your CD4/CD8 ratio and CD4 percentage to see if this is a real change in your immune system.
Hi Emily and thanks for getting in touch.
Please don’t worry.
Your CD4 count is within the normal range (for those living with and without HIV).
The CD4 count of a person ranges from 430 to 1690 cells/ml.
As long as the number remains 500 and over that means you maintain very good health and a robust immune system.
Your doctor will probably keep monitoring this and will alert you if this is required.
The most important feature of your blood tests is the viral load.
As long as you remain undetectable your immune system is protected.
You can read more about CD4 here:
https://i-base.info/cd4-count/
For your other tests other lifestyle factors can play a role too.
For example: if your diet or alcohol consumption changes that might influence your liver function.
Same with cholesterol: if your cholesterol is increasing (see diet) that might influence your liver function.
As long as your results remain within normal range, you don’t need to be concerned
Hi
My cd4 count has dropped
I have switched 14 months ago from genvoya to biktarvy
After the first 7 months on biktarvy, my cd4 count went from 500 to 900 then 7 months later dropped to 500
Is there any reason ? Is it bad?
Hi Halala, without more details of your HIV and treatment history it is difficult to comment. When you say your viral load is good, please can you say what the number is and whether this is undetectable. Please also ask the doctor if your CD4 percentage (CD4%) was tested and whether this has changed over time.
How long have you been on treatment altogether and do you know the name of the meds you used before?
My cd4 count has dropped from 597 to 157 ever since my director change my tablet to Trivenz.
My viral load is in good condition, but does this mean Trivenz is not working for me? Or is there something wrong with my full blood count?
Hi Mike,
A drop in appetite doesn’t mean your CD4 count has changed. Your CD4 count is very good and shows that your immune system is still very strong. Changes in appetite can be related to stress. Do you have any support to deal with your recent diagnosis?
I was tested positive just 2 week ago n my CD4 count was 465 but am worried it must have dropped as I lost appetite 4 some days. wats do I do