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HIV around the sperm
Feb 8, 2009

Hi Dr Bob!

As you said in my (unusual viral trend?) post my viral load shot up from 206 to 535 in 2 weeks :) so after a week on susitva and truvada my doc has taken me off all meds.

quick question - How much virus actually hides withing the fluid around sperm? and how quickly does a virus replicate? I am asking because technically if i can masturbate faster than the virus replicates will i significantly decrease the amount of virus.

PS even if the answer is no i am still going for it! will be called the Thomas trial!

Response from Dr. Frascino

Hi,

Glad to hear your CD4 count (not "viral load," by the way) increased as predicted.

As for trying to beat HIV by beating Mr. Happy, sorry, that won't work. HIV can replicate billions of times per day. I'm guessing unless you're Italian you can't "burp the nephew" quite that much on a regular basis without inducing friction burns and repetitive stress carpal tunnel syndrome. But, if you want to try, I'll alert the Guinness Book of World Records, OK?

Dr. Bob

Unusual viral trend? Feb 2, 2009

Hi Doc,

Just to pick your brains!

I was diagnosed + during quite an intense seroconvertion illness in october with a viral load in excess of 10 million and cd4 at 250.

within a month my cd4 went down to 200 and viral load dropped to 7 million

(having bloods taken weekly btw)

few weeks later my cd4 went up to 240 and viral load down to 3million

now my cd4 has gone down to 206 and viral load has dropped to under 1 million...started sustiva and truvada yesterday, but what i want to know is is this a normal trend? my doc tells me i have rewritten the book for them and he really is not quite sure what to expect from me next.

Response from Dr. Frascino

Hi,

No, I don't think you've rewritten the book by any means. You report you were diagnosed during an intense seroconversion illness. Consequently you were very recently infected. The immune system response to HIV infection is complex and for a period of several months after primary infection the CD4 count and HIV plasma viral load can fluctuate quite a bit as the immune response kicks into gear. Eventually you'll reach a "viral set point" and your CD4 counts will stabilize as well.

I hope you are being followed by an HIV specialist physician. If not, you should be.

The best way to explain your numbers is to look at your HIV plasma viral load. It began in excess of 10 million, fell to 7 million within a month and then fell further to 3 million and now it is under 1 million. This is to be expected. As your immune system kicks in, it begins to fight HIV and the viral load drops. Consequently your trend is as expected. Your CD4 count has been between 200 and 250 during this same period. There is some variability with CD4 cells related to diurnal variation and also multiple other factors, such as concurrent illnesses. The change form 240 to 206 really isn't significant. Once your viral load stabilizes, I would anticipate your CD4 cells to rise somewhat, even if you didn't start treatment. That said, I have no qualms about your starting treatment now. Early intervention may well prevent immune activation and preserve immune functioning.

The bottom line is that your viral load trend and CD4 counts are not unusual or unexpected.

Good luck.

Dr. Bob


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