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scared of superinfection, embarrased to discuss with my doctor

Mar 16, 2008

Dear Dr. I am a 29yo male. I was recently infected through oral sex with HIV1 (December 2007). 3 weeks after, I had the seroconversion sydrome and in January, I tested positive with elisa. My numbers on January 15th were CD4:555, CD4%:36, high p24 antigen levels, no viral load test done. While still in shock, denial and depression, I had receptive oral sex with two men in late January (not putting them in risk), now realizing the stupidity of my actions. Now I am really scared to death of the possibility of superinfection. For the past two weeks, I have inflamed and bleeding gums and frequent canker sores in my mouth. On March 5th, I had another analysis done. CD4:555 again, CD4%:28, viral load 107000. My doctor was concerned about still having the viral load so high. She told me that normally after 12 weeks of infection, the viral load should have settled to a much lower value. I am really concerned about being superinfected. 1)In your opinion, is it normal to have such high viral load values after 3 months of infection?? 2) Could this be due to the fact that perhaps I got superinfected? 3) Should I be alarmed that my CD4 percentage has decreased? 4) On February 28th, I had a tetanus, diphteria, polio shot, would that possibly interfere with the results? If so, with such a high viral load number? I am really embarrased to discuss the possibility of superinfection with my doctor and I am really freaked out at this point. We will do new test in a month but please please let me know what you think about my lab values. I am really afraid that my disease is progressing fast despite my very recent infection. Please answer.

Response from Dr. Holodniy

1. Yes. 2. Perhaps, but unlikely. 3. It is a significant decline, but still essentially in the normal range. When I see abrupt changes like that and nothing else appears to be going on, I just repeat them. 4. Yes, immunizations could account for that.

Tell your doctor what you did. Also, I would suggest getting a resistance test now. Although you don't need treatment, it is important to know whether your transmitted virus is a drug resistant strain.

Estimating CD4 count/percentage from Lymphocytes/Leukocytes percentage

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