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Apr 16, 2006

Okay, it's me again:

20+ years untreated

viral load undetectable for over 7 years

when it was detectable it was never higher than 54

So the gist of the situation, if I understand it correctly, is that HIV's very presence in the body is gradually wearing down the immune system, irrespective of the viral load. So, since my CD4 is now faltering, HIV is and has been having a deleterious effect on me over the years, and I should probably expect that to continue, and treatment is a question of when rather than if?

Meanwhile, my "percentages are good"; if 200 is what you don't want to go below when it comes to CD4s, what's the threshhold of percantages going bad?

Finally, this may be moot depending on your answer to paragraph number one, but in an answer a few weeks ago you alluded to coinfection increasing the odds of progression. Were my HCV regimen to be successful, could that possibly arrest any further HIV deterioration? Or is it too late to turn that train back?

Response from Dr. Holodniy

Treatment is probably in your future. The threshold for CD4 count is an absolute count < 200 and a CD4 percent < 14%. HCV could be contributing to the CD4 slide. We don't know enough about the natural history of immune recovery in people who have HCV treated first and then their HIV. My thought is if you remove one viral stimulus(HCV), which could be activating your CD4 cells and causing them to be destroyed sooner, you might arrest the process.

Western Blot result
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