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Set point

Sep 3, 2007

You frequently refer to the CD4 count and viral load reaching a set point after a time after initial infection. To me that sound like HIV reaches an equilibrium and the two number won't vary much with time. A set point sounds like a static unchanging value implying if the set point is a CD4 count above 200 the patient won't get AIDS.

But it's also said that CD4 counts will decrease in almost all HIV pos. patients each year (40 -50 cells I think the number was.) Almost everyone will end up with a CD4 count so low they will end up with AIDS unless on meds so how is that a set point?

Response from Dr. Holodniy

I don't beleive I have ever said that the CD4 count reaches a set point. The set point refers to viral load level after acute infection and is a rough estimate of viral stability for some period of time. Many factors can affect what that number is and how long it might be maintained over time. From many natural history studies, CD4 count will decline over time, and the higher the viral load over time, the greater the decline in CD4 count. Obviously HIV treatment can arrest this trend.



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