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should i start therapy, decreasing vl and cd4 count

Aug 2, 2009

Can you please help me interpret my disease progression based on my average cd4 and vl counts for each of the past several years? Also curious if you would recommend that I start meds at this point in time? Thanks!

2005 cd4 616 vl 6500

2006 cd4 575 vl 6000

2007 cd4 480 vl 10500

2008 cd4 483 vl 8500

2009 cd4 440 vl 2350

Response from Dr. Holodniy

You don't indicate what your CD4% is with each of these time points. Your viral load has remained relatively low for the last 4 years. There is the appearance that the absolute CD4 count is declining. I would want to know that CD4% as well, as this is a more stable number over time, and absolute CD4 counts can vary for a variety of reasons. If the CD4% has decreased by >3%, then the absolute CD4 count decline is likely real. If the CD4% has remained relatively constant, then the absolute count changes may not be significant. There is no urgency to start HIV treatment. But if the CD4 absolute and % are both declining, I would favor starting treatment soon.

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