My friend was diagnosed as having HIV about 3 months ago (April 08), she had gone to her GP about swollen lymph nodes and they did a HIV test. She was HIV neg in March 2007, and we think she possibly went through seroconversion in July 2007. Her first blood came back as CD4 240 and viral load 50000. She is not on meds yet but has to go back to the HIV clinic in 8 weeks. Her CD4 is low, but could it go up on its own because it is a recent infection (being neg in March 07)? Or if she needs to start meds sooner, is this going to have an impact on her prognosis? How quick could her CD4 be declining, is it possible that her next CD4 could be in single figures? From the outside you wouldn't believe that damage has been done to her immune system. She has lost a little weight, especially in her face but not her apetite and she continues to go to work and have fun with her friends at weekends. I am woried that should her CD4 continue to decline rapidly, she will be diagnosed with aids at her next appt, 5 months after being diagnosed with HIV. I am not sure how she will cope with that mentally, she seems to be coping so far, but that maybe too much too quickly! Thankyou. Anon PS do enlarged lymph nodes come up after a recent infection or can they swell at anytime during an infection?

CD4 cell conts may be low and viral loads high for several (up to 6 months) post seroconversion so generally we look for consistency over time before deciding if treatment is needed. This will generally mean a few CD4 and viral lod tests after the fist HIV antibody test. Some folks need treatment soon after seroconversion, others may not. 4-8 weeks between tests is not unreasonable although if she is worried by the first tests it may be better to gt a second test sooner than 8 weeks. She should also have a resistance test and have her hepatitis B abd C checked. Increases in lymph nodes can occur at any time and so don't have a prognostic significance. It is good that the HIV have been diagnosed so quickly and this should mean that she will be optimlly managed and avoid illnesses related to the HIV. If that requires early treatment then that is for the best and she can feel that she is actively doing something to fight the virus right form the start. I am sure your kind support is a great help to her Kind Regards Dr Moyle