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newly infected HIV and Syphilis
Apr 20, 2003

Dear Dr Holodniy, In October 2002, I assume I was infected with HIV and Syphilis. After a skin rash, I tested positive for syphilis in February and later for HIV in March. After taking three peniciline shots and fighting the syphilis I have been feeling very well. The results of my first HIV blood test were : 640 T cells , 107.000 viral load(considered high I suppose).Before deciding to take retrovirals, my doctor suggests a treatment with infusions of immunoglobulin to keep the T-cells high as now and bring the viral load down, together with a healthy life including good nutrition and sports. Is it normal such a high viral load at the beginning? Is it due to the former syphilis infection and might go down later on? How many test blood results do I need to see reliable results? Have you got experience with the immunoglobulin treatment?Will you advice to start right away with the retrovirals? I am feeling very healthy and so far I had a normal healthy life. Your site is excellent and I thank you in advance for your support

Response from Dr. Holodniy

After about 6 months of infection, the body and the virus arrive at what is called the setpoint of viral load. HIV viral load levels are very individual specific. They can range from undetectable to > 100,000/ml, in the absence of treatment. It is also true that additional, other infections can transiently raise viral load levels, and with the clearance of those infections, viral load goes back to a lower baseline. I would vote for repeating the CD4 count and viral load before making any decisions about treatment. Based on your CD4 count, which is quite good, you can afford to wait and not rush into treatment. If your viral load remains > 100,000/ml, you will probably be facing treatment earlier rather than later. If it has settled down to something, say < 10,000/ml, watchful waiting is the appropriate course.



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