The viral load is more important, since this indicates your virus is not replicating. Since your CD4 is in the 500s this means your immune system is working well.. What I would say is that the CD4 fluctuates according to the time of day and whether youve eaten before your blood tests or not. So in April I got my bloods done in the morning without food and my CD4 was 396. I repeated my bloods last Friday September 13th in the late afternoon after eating and my CD4 was 518. The only problem was my overall cholestorol was 5.3 and it should not be over 5.0
This could be because cholestorol should be tested on an empty stomach, but I will reduce the saturates in my diet nonetheless to be on the safe side. I will share my blood results here again for the benefit of the Team.

Viral load. Because if it's increasing then the need is to determine why. Because you always want to have the lowest possible one.

It fluctuates in my previous test I have 650 and in my latest 850. Don’t worry you are doing ok

Congratulations Brad now just keep them at that level. Your doctor is right they will go up and down depending on various things in your life but you will be positive for a while so you will start to lessen your concern regarding your numbers and start to improve your quality of life. 👍👍👍👍👍👍🌈🌈🌈💥

I want to say both numbers are very important. Viral Load is the amount of virus in your blood, the higher the number the lower the CD4 count will be and that is what progresses to AIDS. So it's very important to stay undetectable (where the virus is so LOW that is cannot be detected by tests) and the best way to do that is to keep on your antiretroviral therapy, or ART.

Now the reason why I say that the CD4 is very important is think of it this way, your CD4 cells are the foot soldiers that keep you healthy and fight off infections. The lower your CD4 cells are the less likely you will be able to fight those battles. Having a CD4 count above 500 is a really safe place to be. For me right now my CD4 has been hanging around either just below 200 to barely above 200 so I don't have as many foot soldiers working at their best. Having 500 or more CD4 cells indicates a fairly normal immune system with very low chances of infections.

I am also going to throw you a curve ball here too, but another number you should be aware of is the CD4% Helper Cells, this number should be 30-60% in healthy patients. This number tells you what percent of your total lymphocytes (a kind of white blood cell) are CD4 cells. The CD4 percentage is sometimes a more reliable measurement than the CD4 count because it tends to change less between measurements. Think of it this way: 50 pennies may sound more than two quarters, but both are 50% of one dollar.

While the CD4 percentage gives information about the health of your immune system, the CD4 count is the preferred measurement for determining whether your HIV disease is progressing (getting worse). Currently, treatment guidelines for adults are based on CD4 counts and not on CD4 percentages.

CD4 cells are going to fluctuate for a variety of reasons - it just happens. A drop from 653 to 589 isn't really a big deal. Regardless, your numbers are absolutely GREAT! The only real time to "Panic" would be if your CD4 dropped below 200, you started developing opportunistic infections, and the CD4% dropped below 30%, but from what you wrote you are GOLDEN. I am glad that you are undetectable, your CD4 number is great! I really think Biktarvy is doing exactly what it needs to be doing.