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My recent counts
Sep 20, 2008

Hello Doctor. I received my counts today and I am terrified! I am fit and well, with no infections or illnesses however my CD4 Count is 27 and VL is 160k. I am starting medication tonight. What are your thoughts on those numbers...can they be improved dramactically? Does such a low CD count shorten my life expection? Thankyou for your time. Tony

Response from Dr. Frascino

Hello Tony,

Your counts reveal profound immune deficiency (extremely low CD4 cell count) and a high level of HIV viral replication (high HIV plasma viral load). This leaves you at significantly increased risk for opportunistic infections and malignancies. Certainly, beginning antiretroviral therapy immediately is warranted to decrease viral replication and hopefully allow some degree of immune reconstitution (increased CD4 cells). In addition, you should take prophylactic medications to prevent common opportunistic infections (PCP, MAC, etc.). If you are not under the care of an HIV specialist physician, I urge you to consult one without delay.

Can your numbers improve dramatically? Yes, it's possible, but there are unfortunately no guarantees. Working closely with an HIV specialist physician and adhering to your medication regimen are crucial.

Does a low CD4 count shorten your life expectancy? Not necessarily. It certainly increases your risk for HIV-related complications, such as opportunistic infections and malignancies. Should you develop certain of these conditions, they could have an impact on both morbidity (illness) and mortality (survival).

I would advise you not focus on potential illness and death, but rather on staying well. You report you are "fit and well." That's encouraging. It's imperative you focus your energies on staying well.

Tony, I'd also suggest you learn as much as possible about HIV and its treatment as you can. Begin by checking out the information in the chapter "Just Diagnosed" that can be easily accessed on The Body's homepage under the Quick Links heading. There, under the subheading of "Just Diagnosed Basics," you'll find articles entitled "Day One: After You've Tested Positive," "How Do I Start?" and "Ten Ways to Take Care of Yourself When You Have HIV Disease" among other articles. It's a good place to start.

Tony, perhaps it will help you to know that I've been HIV positive since January 1991. Let's get through this together, OK? I'm here if you need me.

Dr. Bob


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