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Recent Infection?

Dec 28, 2001

Hello Dr Holodniy, I was diagnosed with HIV in October of this year. I was quite ill in July with a fever and a terrible throat infection, my consultant initialy told me this was probably due to seroconversion with the virus.My VL was 425,000 and CD4 count was 275. A second test was carried out a month later and the results were VL186,000 CD4 count 263. My doctor appears puzzled by these results as he says my CD4 count should not be as low as it is if this is a recent infection. In you professional opinion, do these results suggest to you a recent infection or not? I should also like to mention that i did foolishly have unprotected sex in June of this year. Your comments would be greatfully appreciated.

Response from Dr. Holodniy

I am a little confused on the timing of the tests. Were the viral load tests performed in October and then in November after your diagnosis in October, or were they performed this summer in July and August when you were sick? Those viral load levels are obviously high and could still reflect levels seen during the acute infection period. The absolute CD4 count could be low for a number of reasons. First we usually never know what the baseline CD4 count is in people prior to infection because there is usually no reason to check it. The normal range for CD4 counts is 500-1500. Thus if you start at a level of 1000, your level after HIV infection might be 500, whereas if you start with a level of 500, you might have a level of 300 after infection. People with acute infection can definitely have CD4 counts like yours. Also it's important to know what the CD4 percentage is. A normal percentage is 30-50%. The percent of CD4 cells is usually a more stable number over time. The absolute CD4 count can fluctuate because of infections, or because your total white blood cell (WBC) count is low. MH

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