CD4 Cells Count in HIV patients

Last Updated on 02/18/2026 by Helal Medical

CD4 cells are a type of white blood cells. They are T-lymphocytes, also called T cells. These cells have an important role in the immune system against bacteria, viruses, and other pathogens. CD4 count usually becomes low in an HIV patient, especially without HIV treatment. A lack of CD4 cells usually leads to more frequent infections. Normally, it is 500 to 1,600 cells per cubic millimeter.

What is CD4 Cells Count?

• It is the number of blood cells in a cubic millimeter of blood. It is not a count of all the CD4 cells in your body, (Example: CD4= 900/ul)
• A higher number means the person has a stronger immune system.
• CD4 count test used to measures how many CD4 cells you have in your blood. It is not used to diagnose HIV infection. But it is used to monitor ART effectiveness in persons living with HIV. For HIV diagnoses we use the Antibody test, Antigen p24 test or RNA test.

Normal Values

• A normal person has a CD4 count between 500 and 1500 per ul.
• For those living with HIV, a count more than 500 is considered good.
• If the count is less than 200/ul, then the HIV patient is at high risk of getting serious infections. HIV treatment, antiretroviral treatment (ART), will keep the count of CD4 cells under control.

When the count is less than 200 cells/mm3, (200 cells/ul), this means the person is AIDs patient, which is different from HIV patient. In persons living with HIV, the count is around 500. AIDS is an advanced condition in a person with HIV who is not receiving proper medications. In this stage, the immune system is weak. The risk of infection is very high.

CD4-CD8 Ratio Test

• This test looks at the ratio of 2 important types of white blood cells, (CD4 and CD8), in the blood.
• If you have HIV, your CD4 count may be low.
• The ratio can be an indication of the immune system status.
• In addition to HIV/AIDS, it is used in some conditions like infectious mononucleosis and other viral infections. It is also applied in chronic lymphocytic leukemia, Hodgkin disease, and aplastic anemia. Additionally, it is for neurological disorders like multiple sclerosis and myasthenia gravis.

• A question from one of my patients:

i have CD4 = 400. Does it means I have HIV infection?

Answer

HIV is the most common cause of CD4 low count. But this level of 400 can be due to other causes. Infections, autoimmune diseases, immunosuppressive therapy, lymphoma and idiopathic forms can lower CD4 count.

SOURCES

• What does CD8 count mean? (thebody.com)
• https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=cd4_cd8_ratio
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773541/
• https://www.hiv.gov/

If you suspect that you may have symptoms, Helal Medical can help, offering quick, private, and convenient testing options. You may contact us here: Facebook page.

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