Dear Mark - thankyou very much for answering my question so quickly - I just have a couple more questions for clarification. You mentioned with HIV infection the CD8 cells increase and the CD4 cells fall leading to a fall in the CD4/CD8 ratio - how long after infection does this NORMALLY happen - I have been infected 8 months and my ratio is still 1.2 - is this normal and when is it likely this will drop? Secondly you mention that on average without meds patients loose c50 CD4 cells per year -is there a correspondong average fall per year in the CD4 percentage? Finally, you mentioned that you may not start me on treatment if my VL is <10,000. My VL has always been undetectable on both PCR and bDNA - my CD4 is 36 and my CD4 331 - is there any explanation for why I have experienced a fall in CD4 without a detectable VL?

Thanks again for the wonderful service you do - it really makes a difference

Jim

Your ratio is still normal. It usually takes years to fall significantly. CD4 percentage falls about 1-3%/year in the absence of treatment. We don't really know what the fall in CD4 count in you is, because we don't have a preinfection CD4 count and percentage. So we don't really know where you started prior to infection.