Help and Advice

Dear all,

I was diagnosed in June 2015. Started Medication on the spot as VL was extremely high and CD4 very low (24).

On Truvada and Tivicay

Managed it ok ish and I feel I am getting better.

In April 2016 I had a test back home (Ireland) and the results were as follows:

- CD4 920

-VL less than 20

I had another test in July 2016 (In Bangkok) and the numbers were as follows:

-CD4 306 (15%)

- VL less than 40

I am a bit surprised that the CD4 dropped dramatically - I am taking the Med on time. I did miss it ONCE only. I did change the time that I usually take the pills due to the time difference between Ireland and Bangkok. ( as working on a project in Thailand).

Is this normal or there is something wrong? I do not feel sick or tired but the only thing I noticed that I have acne issues (skin) which are similar to the ones I had when I started the medication (June 2015);

May I kindly ask you to shed some light on these following terms / tests as my Dr in Ireland is on holiday for three weeks and no one wanted to elaborate and they were asking me to wait until the Dr is back. I would be grateful if you could help to put my mind at rest. I did research but lots of medical terms / complicated which I could not understand anything.

1- Hematocrit was 39.9 % ( I understand the normal range should be 40 - 54 %).

2- MCHC 36.1 % DL (Normal rage 33- 35 )

3- AST (SGOT) AST ( SGOT) 43 (normal range 0- 35)

4- HDL Cholesterol 29 (normal >40)

Since I recevied the result and I am all over the place and I feel that I am back to the start / scratch !!!

thanking you in advance.

I look forward to hearing from you

Many thanks - L

8 Replies

  • Dear L,

    Firstly, and most importantly, don't worry.

    It is normal for us to have fluctuations in our test results. The names and terminology of tests and the results is confusing at best.

    Because I am at heart, lazy, I am going to paste in the reply I gave to a similar question that was asked by another member some time ago.


    Dear ****,

    Please do not worry too much about individual CD4 test results.

    Your CD4 count can change quite a lot during the day, or if you have a common cold, or if you have just had a hard night out a day or two before your blood was taken.

    The difference between the last two tests is only 20, this could easily be accounted for by the natural fluctuations one normally has in CD4 counts. This type of fluctuation is normal regardless of your HIV status.

    While we want your CD4 count to go up this is normally a reasonably slow process it can take over a year to get the count where we want it to be. In addition to all this there is a wide range of 'normal' CD4 counts depending on the individual. My own CD4 has rarely been above 600, my husbands is rarely below 700 and often above 800. We have both been living with HIV for over 18 years, go figure?

    So, don't worry about individual test results, look at the trend over time. It is normal to have peaks and troughs in your CD4 count. The three test results still show an overall improvement in your CD4 count.

    Finally, I have been on the same combination as you are on now and never had any problem with it I found it very easy to take and very affective in fighting the virus.

    I hope all this help put your mind at ease.

    Kind Regards,



    Regarding your individual blood test results there is a good web site you can use to read up about them. Below is the link to the first test you mentioned in your list.

    As you will see the Hematocrit test is part of a full blood count (FBC) the FBC covers a host of tests for different constituents of blood. My last Hematocrit % was 0.456% in February this year. Over the last two years it has bobbed up and down mostly within range but once or twice it has been outside of the normal range.

    Just keep in mind that this is all new and strange to you right now, as time goes on you will feel more comfortable and in control of things and I hope much more at ease.

    Remember we are all here for you.

    I hope this helps tide you over until your Dr gets back and you can discuss everything with him.

    All the best for now,

    Kind Regards,


  • Dear Paul, Many Many thanks for your swift reply. I really appreciate it. I will read a bit to gather more details.

    May I ask you one more question, If I have sex with someone without condom (unprotected) ( VL less than 40 and I am on medication), is the other person at risk to get HIV or not.

    Have great evening.


  • No problem.

    Just follow this link. It should, I hope, answer your question.

    All the best,


  • In my 33 years of dealing with the virus I have noticed many things can change the CD4 count including sinus infections, colds, stress or just about anything that would effects the bodies immunity. These can be normal fluctuations due to your immune system fighting common problems and are probably not related to the HIV at all since the viral load which is the amount of copies in the blood are staying pretty consistent. If you were experiencing high stress levels relating to your job and travels, I get travel anxiety too, then these could explain the drop in helper cells. Stay on the medication until you see your doctor again in a week or two and try not to worry. Back when my CD4's were hanging near the 50 mark I worried a lot also but my immune system has recovered quite well and yours will also. The only thing to be cognizant of regarding the CD4 count is when and if it drops below 200 we become more susceptible to PCP pneumonia and other opportunistic infections so if it does get that low you may have to take Bactrim as a propahlaxis until your counts get more stable but just discuss this with your doctor if and when that time ever comes.

  • Dear Survivor83. Thanks a mil for your mesg. I'm a worrier especially I was diagnosed. You are right. I have been travelling a bit for work. Stressed a bit. weather changes. No sleep recently. I have cold due to weather changes. I hope things will be fine. I started with cd4 23. Was over the moon when the cd4 reached 900+ and now dropped. Will see how things go. I really appreciate your reply. Take care of yourself and have a wonderful day. X

  • It's not only that the results fluctuate but sometimes the reliability of the tests isn't great, even the best pathology labs make mistakes or can have flawed results.

    I was told that viral load tests are only accurate to a factor of 3, that would vary on the individual lab.

    It's the big picture that counts.

    You can always ask for a re-test if unsure.

    I never worry now so long as my VL is under 100 on the test (if it's higher I ask for resistance tests).

    I rarely worry about my CD4 as its just a snap shot and a very small part of a much larger picture. Did you know they sometimes test CD5 for example too and within a CD4 test there are also percentages that can be important too - they define CD4 as a proportion of your whole white blood cells [i think].

    Be happy.


  • Keep in mind, that T-cells change even throughout the day. Alot of things affect t-cell counts. What you should pay attention to is the Viral load. But, it's not unusual to have spikes and drops. I've been Poz for nearly 30 years,and have witnessed many frightening lab results. You should only worry if it continues with your next few blood tests.

  • Dear Codyodie, I hope you are fine and thanks a mil for your advice. much appreciated. I will keep my fingers crossed for my next blood test. you take care of yourself too.

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