Dr. Sowasdky, thank you for answering my question. About 7 weeks ago I had unprotected sex with my boyfriend who "pulled out". A couple of weeks later we had protected sex. About a week 1/2 ago I began experiencing body pains especially in my legs and am terrified it is the acute viral syndrome. I got tested for HIV a few days ago and was negative, but they also did a CD4 count. I got the results today: five hundred eighty something and 43%. I've read that normal CD4 counts range from 500 - 1500. I'm concerned that my low CD4 count means I have HIV. About two 1/2 weeks ago I was given antibiotics for a sore, pussy throat from which I have recovered about 1 1/2 weeks ago. Would this affect my CD4 count? How long does it take to rise after being sick? I can't think straight and am really in BAD shape mentally. The doctor who performed the CD4 test says its "normal" but I just can't beleive it. It seems so low on the normal scale. Please help me, nobody seems to give me any straight answers. Thank you.

ANSWER:

Hi. Thank you for your question. Before answering your question regarding CD4 counts, please see the message, "A MESSAGE FROM RICK SOWADSKY ABOUT SYMPTOM QUESTIONS" regarding the symptoms of Acute Viral Syndrome.

In all honesty, I don't even know why they did a CD4 cell count on you in the first place. Doing CD4 counts are only recommended in persons known to have HIV, or other diseases of the immune system. CD4 counts CANNOT be used to diagnose HIV! This is for two reasons. First, a person can have a normal CD4 cell count and still have HIV. Second, there are things other than HIV that can lead to a low CD4 cell count. There is clinically no reason to do a CD4 cell count to diagnose HIV infection. In persons with HIV, prolonged abnormally low CD4 cell counts aren't even seen until literally years after infection. Again, CD4 cell counts cannot be used to diagnose HIV infection, especially after a recent possible exposure.

CD4 cell counts can be highly variable. During an infection, the numbers tend to rise. After an infection, the numbers decrease. Generally speaking, these are the general ranges for CD4 cell counts.

800-1200 or greater than 29%: normal range. 200-500 or 14-28%: Initial damage to the immune system. less than 200 or less than 14%: Severely damaged immune system.

In persons with HIV, a CD4 cell count less than 200 or less than 14% meets the definition of AIDS. There are other diseases of the immune system (other than AIDS) that can lead to abnormal CD4 cell counts.

Based on what you told me, there's no evidence that there's even a problem with your immune system. There really isn't any need for you to be even doing CD4 cell counts, unless you are found to have HIV, or other diseases of the immune system.

As to when to get an accurate HIV antibody test:

The AVERAGE period of time that an infected person will show positive on the test is 25 days. This is an average, so not all people will test positive by this point in time.

The USUAL period of time that an infected person will show positive on the test is 3 months. This means that most (but not all) infected people will show positive on the test by this time.

The MAXIMUM period of time that an infected person will show positive on the test is 6 months. By this point in time, more than 99% of infected persons will show positive on the test. This is as accurate as any test in medicine could ever be.

For the most accurate test result, you must wait 6 months after your last possible exposure to the virus (or anytime afterward). At 6 months, the tests are more than 99% accurate. If you get tested before the 6 month waiting period, you could have the infection but the test won't pick it up.

Also, if a person tests negative at the time that they are showing symptoms, that indicates that their symptoms are not AIDS related. A person first shows positive on the test (by 6 months after infection), and then later shows symptoms (an average of 10 years after infection). So if a person tests negative at the time that they're showing symptoms, that indicates that the symptoms are not AIDS related.

Please do not let your CD4 cell count frighten you, or make you think you have HIV/AIDS. There's no evidence of that. If you are concerned that you have HIV, all you need to get is an HIV antibody test. These tests are what are best used to diagnose HIV infection, not CD4 cell counts.

If you have any further questions, please feel free to call the Centers for Disease Control at 1.800.232.4636 (Nationwide).