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Relation between CD4 count and Viral load

Jun 24, 2009

Dear Doctors, Thanks a lot for all your answers. You really dont know how much you are helping for people like me who are living in the remote areas of the world.I just want to know the relation between CD4 count and viral load . i guess if the CD4 count is high viral load should be much lower ??? I am unable to interpret my lab results. 2 yrs back my vl was 500 and CD4 was 300 now Cd4 is 150 and VL is 5000 .I heard that people with Vl 5000 will have much higher Cd4 counts. So is my less Cd4 less because of other infections like Urinary infections etc which i had recently ? Can you please guide me which healthy food i need to include in my diet to get my CD4 much higher . Thanks a lot for your help

Response from Dr. McGowan

Thanks for your compliment and your question.

The viral load is the amount of virus in the liquid portion of a drop of blood. The CD4 count is the number of CD4 cells also in a drop of blood. The CD4 cells are infected by HIV and their numbers can drop over time due to HIV infection. The CD4 cells are white blood cells, also called "helper cells" that keep the immune system in proper balance. When their numbers go down the immune system cannot effectively block infections and AIDS can result.

Usually, the higher the viral load, the more rapid the drop in CD4 cell count. It is like a car moving down the road toward a house. In order to know how long it will take to get to the house you need to know the distance the car is from the house and the speed the car is traveling. When making predictions about how fast HIV may progress it is the same. The question may be "How long will it be before my CD4 count drops below 200 and I have an AIDS diagnosis" The "distance" in this case is what the CD4 count is now (say 500), and the "speed" is the height of the viral load. So, a person with 500 CD4 cells and 5,000 viral load will take longer to drop to 200 cells than a person with 500 CD4 cells and a viral load of 100,000.

Early on after infection it is possible to have a high CD4 count and a high viral load, but the CD4 will usually drop fast.

In your case you have had a relatively low viral load and a lowish CD4. Which means you have probably had HIV for a while, it would take a few years to drop the CD4 count to 150 with a low viral load. The CD4 has dropped over 2 years, which will happen even with a low viral load.

While diet is always good for your immune system, especially green/leafy vegetables. The only thing that will effectively bring up the CD4 count and restore the immune balance is to suppress the virus that is causing the decline. If you have access to antiretroviral treatment, this would be the time to start.

Good luck,


VL 6000 time for treatment?

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