Late diagnosis and low CD4s

In the UK, about 40% of all new diagnoses are made when the CD4 count is already less than 350.

About 1 in 5 (20%) are even later, with a CD4 count below 200.

Late diagnosis can be related to:

• Fear of testing.
• Denial: “it will never happen to me”.
• Fear of stigma and prejudice.
• Lack of up-to-date information about HIV and treatment.

Some people only find out they are HIV positive when they already have a low CD4 count. This often means starting treatment on the same day that you first see an HIV doctor.

If you have serious symptoms and are admitted to hospital, you might need other infections treated first. ART will be started shortly afterwards.

Even with a very low CD4 count – even below 100 – if you take your drugs carefully, you have a good chance that ART will work. Your viral load will drop and your CD4 count will rise to safer levels.

However, starting with a very low CD4 count can cause some infections to activate, such as TB. This is called Immune Reconstitution Inflammatory Syndrome (IRIS) and is serious, but usually easy to treat.

Last updated: 1 June 2022.