My partner is 55 and his HIV test 18 months ago was positive. His three monthly CD4 counts since have been: 536/631/568/602/559/507 and his VL count which was 7110 went down to 4900 and was 10400 last October and 19000 in May.

1. Can you assess how long it will be before he will have to start medication?

Many thanks

Some people get sick soon after getting HIV, others remain well seemingly indefinitely. The average time from acquisition to illness is about 8 years.The rate and pattern at which CD4 declines is quite variable and factors beyond viral load level, such as individual genetics, viral tropism and immune activation also play a role. There are publsihed data on progression to AIDS by CD4 and viral load. There are tables at http://aidsetc.org/aetc?page=cm-106_cd4_stage . Clearly it is sensible to start well before illness risk increases, current guidelines recommend around a CD4 of 350. The viral load values suggest that you partner will need to start treatment at some point but based on Cd4 it is hard to guess. Doctors are not great at accurately predicting the future in individual cases. The sensible thing is to get educated about treatment, such as by visiting thebody.com regularly (!!), and regularly discussing with the doctor about the timing of treatment

Hope this helps

Regards

Dr Moyle