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Labs versus 10 years average till HIV becomes symptomatic

May 1, 2004

Dr. Holodniy,

Just read a response in which you indicated to someone who received their first labs that a CD4 of 425 and VL of 17,000 was good.

I see a lot of questions from people who say they have recently been diagnosed and the CD4's and VL's given by them are extremely variable. If untreated HIV takes an average of 10 years to become symptomatic and risk becoming AIDS, can you please explain what are typical/average numbers of CD4's and VL's that you see one, two and three years after infection? How can there be so much variance between different people's results and yet an average of about 10 years during which HIV is asymptomatic?

Thank you.

Response from Dr. Holodniy

The variability relates to a persons underlying immune system before infection and the type of viral strain that they became infected with. Some people's systems are better able to cope and control viral replication. On the other hand there are certain viral strains that are more aggressive in infecting and killing CD4 cells. Other factors including age, other viral infections or medical conditions predating HIV infection contribute to increased progression as well.

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