Mar 28, 2004
My girlfriend tested HIV positive in December 2003, following a negative test a month earlier. In January this year she had a CD4 of 341 (21%) with VL of 58,500. A further test in March showed a fall in CD4 to 316 (18%). Her doctor said that thinks that there he thinks an error in the test results is likely and this looks like a long term infection. He has said that he will start treatment if the next CD4 test does not show an increase. I am worried about such a rapid fall in CD4 from what appears to be a recent infection. Is this possible and what is the prognosis?
Response from Dr. Holodniy
These results are at the borderline of being significantly different. We look for CD4 count changes of 50 or more or 3% or more (up or down). You don't indicate what the viral load was at the second test. Regardless of duration of infection, current guidelines suggest starting treatment when the CD4 count is < 350 and the viral load is > 50,000. If on a third set of tests her numbers are at these benchmarks, I would agree that treatment should be started sooner rather than later.
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