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Trends in my labs - your opinion?
Sep 19, 2004

Hello Doctor.

I was wondering if I could get your opinion on my lab results.

My numbers are: 12/2003: 502/304179/20% 01/2004: 468/264000/24% 04/2004: 489/154000/24% 07/2004: 456/71300/19%

I have not yet started meds. I'm male, 42, don't smoke, don't drink, and get aerobic exercise. Except for some enlarged lymph nodes (gone now), I've not had any symptoms. Aside from the HIV, I'm in great health. I was diagnosed HIV positive 12/2003, but I'm not sure how long I've had it (it was my first HIV test).

Is this good news that my body is knocking down the viral load, or is the decrease not very significant? It's basically dropping by half every 3 months! If the VL decrease continues, do you think I'll start to see my CD4 increasing at some point? If not, do you have any guess as to when you think my CD4 count will drop to the point where I will need meds?

Any other observations you can make based on this info will be appreciated!

Response from Dr. Holodniy

Here is a bit of a math lesson in viral loadology. The first 3 viral loads are within assay variability, which is about 3 fold or 3 times above or below a value. Viral loads are also expressed in log base 10 values/ml. Assay variability is about 0.3 log10/ml. So the first 3 viral loads expressed as log10 values are 5.48, 5.42, 5.18 respectively. No real difference expressed that way either. The last viral load is about 4 fold less than your baseline value or 4.85 log10. That would be considered significantly different. I cannot predict based on these numbers where your next set of numbers will be. I don't think your currently need treatment. Another set of numbers or two will help define your curve better.



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