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Acute HIV?
Jan 21, 2006

Hi there,

I found out I was positive in Nov 2005. Prior to this, my last HIV test was May 2003 so I contracted it sometime between then and Nov 2005. One scenario is that I contracted it shortly after my negative result in 2003 or possibly in June/July/August of 2005. Back in 2003 I had the flu for a week which was going around the office although in hindsight it might have been seroconversion. I had a week worth of severe diarhea in the months of 2005 listed above.

Since Nov, I've had 3 sets of labs done and here are the results:

Nov 9: CD4 : 278 CD4%: 20 VL : 17,000

Dec 9: CD4 : 325 CD4%: 20 VL : 12,330

Jan 9: CD4 : 320 CD4%: (didn't have the % at the time of this post) VL : 7,888

My question - is it likely that I'm experiencing Acute HIV infection (i.e the scenario of more recent infection)which is suppressing my CD4 count OR is it more likely that my body is handling the virus fairly well (thus the low VL) and that I was infected back in 2003?

I'm currently on no medications, I feel healthy with no symptoms and my resistance tests showed no resistance to any medications. Also, I realize that I'm on the lower end of a good CD4 count but considering the VL, can I postpone treatment until I see my CD4's dropping? Any thoughts in general?

Response from Dr. Holodniy

I think it is more likely that infection occurred in 2003 and you are in the stable chronic period. You are on the bubble in regards to treatment. Given the low viral load, you can afford to wait on treatment. But if the CD4 percentage drops by 3% or more on two separate tests, I would be inclined to start treatment.



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