Question
What does a CD4% of 8 mean in terms of starting treatment?
7 January 2009. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.
I was diagnosed HIV-positive oa month ago and I am confused by my test results. I know that I have been infected within the last two years as my test in 2006 was negative.
My CD4 is currently 375 (2 weeks before that it was 320 and they suggested starting treatment). VL is 31000, but my CD4 percentage is 8%. I don’t understand what this means as I have been told that my CD4 is now past the ideal threshold for starting treatment although I have to go back in two weeks to see what it is then.
I understand the CD4 count but not the percentage.
Does it mean that I am progressing rapidly?
Answer
The first thing is that you can time to get the results from a few more CD4 and viral load results before deciding anything about treatment.
You need time to learn about your options and with a CD4 count over 300 there is no urgency to start immediately. Even though the UK treatment guidelines recommend starting while still above 350 cells/mm3, this is just a guide.
You can see from your own results that there the CD4 count can fluctuate without necessarily meaning that there is any real change in the immune system.
You need to get a few more results to see any trend. For example if the infection was within the last six months or so, your CD4 count could continue to increase without treatment. Your viral load is also still considered low and you need to see if this is still going down, is stable, or is increasing.
It would be good to check you previous and future CD4% results though.
The CD4 percentage is a secondary marker of immune function that is usually more stable than the regular (or ‘absolute’) CD4 count.
If your CD4% is confirmed at less than 10%, this might be a reason to start treatment earlier, even if your CD4 count remains over 350. Usually a CD4% of 10-12% is thought to be the same as a CD4 count of 200. The CD4% of an HIV-negative person is usually 40-50%.
Again though, you have time to confirm this.
If is does turn out that you have progressed more quickly than average you will still get just as good a response form treatment. This is very common with perhaps 25% people in the UK needing treatment within two years of infection.
Please let us know if you have other questions.
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