Why low cd4 count and low viral load?

Question

I have a friend that was recently diagnosed with AIDS. His cd4 count was 9 and his viral load was 24,000. Why are both of these numbers low? I would think that if his cd4 count was so low that he would have a high viral load. He was hospitalized for pnuemonia for a month and just began treatment.

Answer

Hello,

Yours is a common misconception. Any HIV viral load is typically enough to result in CD4 count reductions, HIV disease and complications. The point that you allude to is that persons with higher viral loads tend to have disease progression more rapidly than those with lower loads and that persons with very low CD4s tend to have higher viral loads.

Another important point is that CD4s obtained while one is very sick (like being hospitalized with pnemonia) generally are affected by the acute illness and may not reflect the "baseline" CD4. Either way, it's likely that your friend does have a CD4 low enough to justify HIV treatment-- I hope that he's tolerating medications well and that his follow up will show clinical and laboratory improvements.

Best of health to both of you, BY