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Viral Load Variance

Apr 28, 2003

Thank you for this wonderful forum.

On January 16, 2003, I was diagnosed HIV-positive and my viral load lab was drawn. One week later, my primary care physician informed me my viral load was 1300. I was relieved at the low number. Three weeks later, my infectious diseases doctor drew my labs again. This time, my viral load was 206,000. I was astonished. Is it unusual to have such a variance in viral load within such a short period of time? My docotr's only answer was that perhaps I was so "newly infected" at the first lab that my viral load had not yet "skyrocketed." I don't think this is the case. I am almost certain that I seroconverted almost a year ago in May of 2002 (I experienced all the symptoms of seroconversion exactly two weeks after I KNOW I put myself at risk).

Do you think the first viral load lab was an error? My doctor wants to draw the viral load two more times within the next two months to get more of a definitive result before any decisions are made about meds.

Incidentally, my CD4 count is 638/38. How am I doing? If you can offer any hypotheses on the why these viral load results were so vastly different, I'd appreciate it. Thank you! Gary

Response from Dr. Holodniy

That difference in viral load values is indeed significant. We consider any variance more than 3 times (3 fold) as being significantly different. In people not on HIV meds, it could be related to other ongoing acute infections or recent immunizations. Alternatively this could be lab error. Your CD4 is very good. I agree with the repeat in numbers. If your viral load is back to 1300, there is nothing to do. Even if your viral load is 200,000 again on repeat, you have lots of time to decide on whether treatment is necessary at this time.

Must I start treatment?
Should I quit

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