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Volatile Viral Load

Mar 11, 2006

Hi, I've known about my status since April 2005. My last negative result was August 2004. My concern is the erratic pattern of my viral load. When first diagnosed, the doctor said the viral load usually peaks at acute infection, comes back down, and gradually comes back up again. My labs don't reflect this curve and my doctor admits I have the most drastic rises and drops she's seen among patients, yet offers no viable explanation for it. My results were roughly as follows: 180K, 90K, 200K, 63K, 190K, 180K. My CD4 count was not as drastic: 380, 420, 520, 474, 364. I just started sustiva + truvada after receiving the results of my last lab and getting the chicken pox. Can something be made of these strange numbers? Thanks

Response from Dr. Holodniy

Those viral loads at first blush look like they are drastically different, when in fact they are not. There can be as much as a three fold (3 times) variability just because of assay variability. Another important number to follow is the CD4 percentage, which tends to be a more stable number than the absolute CD4 count. The absolute CD4 count can fluctuate because of the time of day, or because of other ongoing infections, stress, recreational drug use among other reasons.

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