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Rapid progression with high viral load

May 10, 2009

I am a 45 year old male who became infected in November 2008. I had severe seroconversion illness and was diagnosed mid December 2008 at which time CD4 was 334 and VL of 200,000 copies. Results since were CD4 384 / 20% and VL 650,000 copies by end of February and CD4 393 / 14% and VL 875,000 copies at end of April (6 months from infection). My doctor is saying not to be worried and hasn't raised starting meds yet. My concern is the viral load which is extremely high, and now the CD4 percentage low. Is this in your opinion rapid progression and what are the chances HAART will drop the VL to undetectable, from such a high level, once HAART is initiated

Response from Dr. Holodniy

I understand your concern. Although you can see dramatic falls of CD4 count and percent with acute infection, which usually recover to some higher level, the high viral load and trend of your CD4 count and particularly CD4 percent 6-8 months after infection is concerning. HIV treatment will indeed get you to undetectable. It is not unreasonable to think about starting treatment now.

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