I'm a supportive friend of someone who has recently tested HIV positive. He tells me his viral load over the past two months has gone from 7800 to 355,000...and his CD4 dropped from 290 to 230 in 2 months time. But I don't really understand what these numbers represent...can you help me to understand them in non-clinical terms? Thank you.

I like to use a car analogy about these tests. The CD4 count tells you how far you have to travel to develop AIDS and the viral load level tells you how fast you are going to get there. A normal CD4 count ranges between 500-1500. People with HIV infection begin manifesting signs of AIDS (serious other infections and cancers) when the CD4 count goes below 200. A viral load < 10,000 is considered low and a viral load of > 100,000 is considered high. The higher the viral load the faster CD4 t cells are killed by HIV. Thus a CD4 count of 230 with a viral load of 355,000 would be considered at serious risk for disease progression to AIDS and HIv treatment is absolutely indicated.