Dr. Holodniy- I have been HIV+ for at least 20 years but started meds only in 1998. My T cell count fluctuated between 250-300 but my question has to do with viral load. Just before I began treatment in '98, my viral load was >2,000,000 but since meds it has consistently been between 400 and 800, but never "not detectable". From a practical standpoint, is there much difference between say 400-800, and "not detectable" or should I be concerned that I have never been able to acheive that threshold?

thanks!

Given your longevity with infection, it is probably not so concerning as with a person more recently infected. That said, with your CD4 count, I would like to see the viral load undetectable, as a persistently detectable low level probably indicates that some HIV drug resistance exists. Although you don't indicate what your current regimen is or how long or how many different HIV meds you have taken since 1998, you might want to consider adding or changing some of your HIV meds to get your viral load to undetectable. That might also improve your CD4 count.