What does my CD4 count mean?
Posted by Pozziepinoy on 8:07 PM
(Source: 100 Questions and Answers About HIV and AIDS, 2nd Ed., by Joel Gallant, M.D., MPH)
Your blood contains red blood cells (RBC's), white blood celles (WBC's) and platelets. Lymphocytes are a type of WBC, and the CD4 cell is a type of lymphocyte, the one most affected by HIV. The CD4 count measures the health of your immune system. It should be checked regularly (usually every 3 to 6 months) if you're not on therapy because it measures the amount of damage done by HIV and iit is the most important test for deciding whether you need to start ART or prophylaxis (prevention) for opportunistic infections. The CD4 count almost always increases with effective ART, but how much it will increase is hard to predict.
Once you're on ART, the viral load becomes more important than the CD4 count as a measure of your response. If you're viral load is undetectable - the goal of therapy - it's unlikely that you would make any changes based on the CD4 count. An ideal response to ART is to have an undetectable viral load and a CD$ that's above 500. When you reach that goal, its not necessary to measure the CD4 count more than once a year.
The CD4 count can vary from day to day - even from hour to hour. It can drop temporarily when you're sick or have been vaccinated and can be affected by the way it's processed in the lab. Don't pay too much attention to a single count and don't get too worried (or excited, for that matter) about a single count that's not consistent with previous counts. It's the trend that matters, not one number. When in doubt, you can also look at the CD4 percentage - the percentage of your lymphocytes that are CD4 cells. This number doesn't vary as much as the CD4 count, so if your CD4 count has changed but your CD4 percentage hasn't, chances are it's not a real change. And once your CD4 count is normal (above 500), don't worry about changes within the normal range, Normal is normal. If it's 650 once, 710 next, and 580 after that, those are great results.
CD8 (or CD8 lymphocytes, or T-suppressor cells) are also affected by HIV infection, but it's not necessary to measure them, since we don't use the CD8 count or the CD4/CD8 ratio to make treatment decisions.
Your blood contains red blood cells (RBC's), white blood celles (WBC's) and platelets. Lymphocytes are a type of WBC, and the CD4 cell is a type of lymphocyte, the one most affected by HIV. The CD4 count measures the health of your immune system. It should be checked regularly (usually every 3 to 6 months) if you're not on therapy because it measures the amount of damage done by HIV and iit is the most important test for deciding whether you need to start ART or prophylaxis (prevention) for opportunistic infections. The CD4 count almost always increases with effective ART, but how much it will increase is hard to predict.
Once you're on ART, the viral load becomes more important than the CD4 count as a measure of your response. If you're viral load is undetectable - the goal of therapy - it's unlikely that you would make any changes based on the CD4 count. An ideal response to ART is to have an undetectable viral load and a CD$ that's above 500. When you reach that goal, its not necessary to measure the CD4 count more than once a year.
The CD4 count can vary from day to day - even from hour to hour. It can drop temporarily when you're sick or have been vaccinated and can be affected by the way it's processed in the lab. Don't pay too much attention to a single count and don't get too worried (or excited, for that matter) about a single count that's not consistent with previous counts. It's the trend that matters, not one number. When in doubt, you can also look at the CD4 percentage - the percentage of your lymphocytes that are CD4 cells. This number doesn't vary as much as the CD4 count, so if your CD4 count has changed but your CD4 percentage hasn't, chances are it's not a real change. And once your CD4 count is normal (above 500), don't worry about changes within the normal range, Normal is normal. If it's 650 once, 710 next, and 580 after that, those are great results.
CD8 (or CD8 lymphocytes, or T-suppressor cells) are also affected by HIV infection, but it's not necessary to measure them, since we don't use the CD8 count or the CD4/CD8 ratio to make treatment decisions.
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-Pozziepinoy-
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