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Viral Load/Cell Count vs. O.I.'s
Jul 27, 2000

I recently heard some very unnerving stories from a friend who interviewed AIDS patients about 4-5 years ago and witnessed many traumatic maladies such as spreading warts on some previously "healthy" patients, according to her, and other things such as rare forms of cancer.

I have a loved one who was recently diagniosed with HIV, fortunately early. His TCell and Viral Load counts are considered perfect for succesfull combination therapy. So what I was wondering is if certain infections and cancers are very relative with the ongoing viral load and TCell count, or are there many or any cases with healthy patients responding very well to therapy with very low or nontracable viral loads who still develop terrible complications before full-blown AIDS. This person who said that these people were under good treatment is not a medical professional and made it sound like the immune system is still very weak even with succesful ongoing therapy. What is the real case?

Response from Dr. Feinberg

A normal inflammatory response to infection requires a healthy immune system. Some HIV+ individuals have such a dramatic improvement in immune function after starting HIV therapy that infections that may have been developing slowly (what we call "subclinical" infections, with few or no symptoms) at the time HIV treatment was begun will suddenly manifest symptoms because their immune system is now capable of such a response. This is often termed "immune recovery syndrome", and generally has a good outcome. Sometimes it will require specific therapy for the opportunistic infection in question, and in other cases just continuation of potent combination HIV therapy is sufficient and the symptoms resolve. However, is is important to know that people may not regain an entirely normal immune system after HIV treatment, although they do have significant improvement.

Inflamed liver

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