CD4 count reference ranges
| CD4 Count | Interpretation |
|---|---|
| 500–1,500 cells/µL | Normal immune system |
| 350–499 cells/µL | Mildly reduced — treatment recommended |
| 200–349 cells/µL | Significantly reduced — high infection risk |
| <200 cells/µL | AIDS diagnosis — very high risk of opportunistic infections |
| <50 cells/µL | Severe AIDS — risk of CMV retinitis, MAC, cryptococcal meningitis |
CD4 count and HIV treatment
When to start antiretroviral therapy (ART)
Current guidelines recommend starting ART for ALL people with HIV regardless of CD4 count — the earlier, the better. CD4 count is used to monitor immune recovery on treatment. With effective ART, CD4 counts typically rise by 50–150 cells/µL per year. The goal is to achieve a CD4 count above 500 cells/µL. People with CD4 <200 also need prophylaxis against Pneumocystis pneumonia (PCP) with trimethoprim-sulfamethoxazole.
CD4 count vs HIV viral load
| Test | What it measures | Clinical use |
|---|---|---|
| CD4 count | Immune system strength | Monitors immune recovery, predicts infection risk |
| HIV viral load | Amount of HIV in blood | Monitors treatment effectiveness — goal is undetectable |
Questions to ask your HIV doctor
- What is my current CD4 count and is it rising on treatment?
- Is my viral load undetectable?
- Do I need prophylaxis against opportunistic infections?
- How often should I have my CD4 and viral load checked?
Medical Disclaimer: For educational purposes only. Always consult a qualified healthcare professional for diagnosis and treatment.