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So healthy, yet AIDS status

Mar 5, 2006

Thank you, Dr. Holodniy for your analaysis and advice regarding my status questions you answered March 3 (My question subject line was "Swing in CD4/Load". You advised me to start meds ASAP. I am arranging an appointment with a doctor in Bangkok now and plan to see him by next weekend (within a week that is). I just want to ask one more question, . . and perhaps my question and your answer can help others to realize the importance of getting monitored often: I seem perfectly healthy. I have not had even a common cold since I got over a rather long (4 months: May - September 2005) initial infection period, in which I did lose weight and suffer fevers. Since then I've regained weight naturally, am naturally muscular as always, have no lesions, no tiredness, no sign of aging or wasting or anything that I can see. The question: Is it normal to be so healthy appearing and yet have a clinical AIDS diagnosis? I guess I would like one more question: Is it normal for a person to go from initial infection to AIDS diagnosis so quickly -- in just 9 months? Like I said, maybe someone else out there thinks they are quite healthy, as I did (and do still, really), . . and are unwisely putting off their CD4 and Viral Load testing. (I last had mine done before this most recent February checkup in September; I went from 340 CD4 and 15,000 viral load to 153 CD4 and 70,000 viral load in that time. I'm really quite shocked by what seems an unusual decline in such a short period of time.) Thank you for being there, Doctor.

Response from Dr. Holodniy

People can definitely appear healthy and normal for years and be progressing to an AIDS diagnosis without symptoms. In fact many new diagnoses in the US are not new infection, rather people who have had infection for a long time and either did not know or are in denial, and then come to medical attention either for testing or because they have developed an AIDS diagnosis (like an opportunistic infection) and then get tested and are found to be HIV positive.

It is not normal to have that kind of progression, although has been described. Part of the reason depends on what kind of viral strain was acquired and what the underlying genetics and immune system are that a person has. These variables among others help determine progression rates.

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