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Real members of myHIVteam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Sudden fall in CD4 and weight loss

A myHIVteam Member asked a question 💭
Indialantic, FL

I am in ART from 2022, till Oct 2025, viral load was non detectable CD4 was 1300, But after Oct 2025 there is weight loss, i got boils all around body without any reason. ( 5 or 6) . The CD4 has come down to 523. Doctor says the boils are due to bacterial infection, i suspect the virus has become drug resistant and worried please provide your suggestions. My nose is also blocked

March 6 (edited)
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A myHIVteam Member

Hi Prasad, thank you for sharing your concerns with us. It is completely understandable that you are worried after seeing your CD4 count drop and experiencing new symptoms like weight loss and boils. When we have been undetectable for a long time, any change can feel like a major setback.
Regarding your health concerns, this is NOT medical advice, just information to ask your doctor about. here are a few things to consider:

CD4 Fluctuations: While 523 is lower than 1300, it is still considered a healthy and strong immune level (usually anything over 500 is the goal). CD4 counts can drop temporarily due to other infections, like the bacterial one your doctor mentioned.

Bacterial vs. Viral: If your doctor believes the boils are bacterial, they may not be related to HIV drug resistance. Bacterial infections can cause weight loss and fatigue because your body is working overtime to fight them off.

The 'Drug Resistance' Question: If you are concerned about resistance, you can ask your doctor for a viral load test. If you are still 'Undetectable,' it means your ART is still working perfectly, regardless of the CD4 number.

Nose Blockage: Persistent sinus issues can also impact how you feel overall. It might be worth asking if this is related to the same bacterial infection causing the boils.

My suggestion: Ask your doctor, 'Can we check my viral load to confirm my meds are still effective?' This usually provides the peace of mind you need.

Please keep us updated on how you are feeling. We are here to support you!

March 13
myHIVteam

What could be causing a sudden drop in CD4 count from 1300 to 523 along with weight loss and boils?

It's understandable to feel worried about these changes, but let's look at what might be happening. A drop in CD4 count along with symptoms like boils and weight loss can occur for several reasons beyond drug resistance.

Show Full Answer

What could be causing a sudden drop in CD4 count from 1300 to 523 along with weight loss and boils?

It's understandable to feel worried about these changes, but let's look at what might be happening. A drop in CD4 count along with symptoms like boils and weight loss can occur for several reasons beyond drug resistance.

Your doctor's assessment that the boils are from a bacterial infection is important. Bacterial skin infections can happen even when you're on effective ART, and they can temporarily affect your CD4 count. When your body is fighting an active infection, CD4 counts can fluctuate.

Here's what you should know:

- CD4 counts naturally vary and can temporarily drop during infections or illness
- A count of 523 is still above the critical threshold of 200, though lower than your previous level
- Weight loss can occur with infections as your body fights them off
- Drug resistance typically shows up first as an increase in viral load, not just a CD4 drop

The most important step is to have your viral load checked again. If it remains undetectable, drug resistance is less likely. Your doctor may also want to test for other infections that could be causing your symptoms. Don't stop your ART medications while investigating this. Continue taking them as prescribed. Work with your doctor to treat the bacterial infection causing the boils and monitor your CD4 count and viral load closely over the next few months.

If the infection clears and your CD4 count doesn't improve, or if your viral load becomes detectable, your doctor can run resistance testing to determine if medication changes are needed.

March 6

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