Question

I would like to know what are safe CD4 counts for HIV Positive people & what is the normal CD4 count for unaffected people.

Answer

Thanks for your question. Think of the CD4 count as a continuous number, so there are no exact cutoffs for what is good and bad.

Generally having a CD4 count below 200 would put a person at risk for opportunistic infections related to AIDS. Getting the CD4 count above 200 is the first goal of treatment.

Recent information suggests that if you can get or keep your CD4 count above 500 you can greatly reduce your risk for getting sick from other conditions such as heart, liver and kidney disease that can be linked to imbalance in the immune system. These are not the usual AIDS related conditions, but we now know that HIV can increase the risk for many conditions due to its effects on the immune system.

A "normal" CD4 count will vary from person to person and by which laboratory you have your testing. In my hospital we consider the normal range for CD4 to be 480-1460. One way of getting a sense of what normal would be for you would be to ask your doctor to show you the "CD4 to CD8 ratio". This test gives you the balance between the 2 major types of T cells. When that number gets to around 1.0 or higher, that is normal for you.

Best,

Joe