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Advice for the Newly Diagnosed
Blood Testing & Analysis - CD4+ Testing
CD4+ Cell Range
| Low | Medium | High |
| Less than 300 | Between 300-500 | More than 500 |
- High Range
In general, a CD4+ count above 500 suggests no immediate danger, even though it may represent a loss of half the normal CD4+ cell count (1,000). The 500 level is sometimes cited as the bottom of the "normal" range, but this can be misleading. While an occasional drop to 500 may be normal, a steady or falling count of 500 or even 600 is not normal and indicates suppressed immunity. At the very least, dietary counseling, nutritional supplements, CD4+ cell monitoring, and periodic use of other tests are recommended in this range, whether or not treatments are used. - Medium Range
CD4+ counts in this range indicate significant decline of the immune system. However, serious symptoms are uncommon in this range. Some researchers believe this is the optimum time to begin treatment, especially if the viral load test also indicates significant viral activity. - Low Range
CD4+ counts below 300 indicate the greatest risk of infections. A person with counts below 300 CD4+ may remain stable for many years, especially with careful health management. While some people have warning signs in the form of symptoms before major infections occur, this is not always the case. Some progress directly from apparent health to serious OIs.
It has become common to put people with CD4+ counts below 200 or 300 on preventive treatment against PCP (for example, Bactrim/Septra), along with all people who have already suffered an initial bout of pneumocystis. Regardless of CD4+ cell count, yearly monitoring for tuberculosis is becoming increasingly important.
Blood Testing & Analysis - Summary
No single test gives a total picture of immune health or disease progression, but CD4+ cell testing and viral load taken together are very important. As we learn to manage HIV as a chronic illness, these tests provide rational guidance about what treatments to use, when and when not to use them, and how well they are working.
