Not sure if this will help much but the VL on 8/4 was 490 and 6-7 weeks later was around 6,000. Thanks.

Confused about results and therapy Oct 18, 2009

Dr. Holodniy, thanks so much for your input into this wonderful site. I know HIV affects people differently with wide variance. However, my confusion comes from reading many posts on this site and the fact that some folks have had HIV for many (8-10)years and still have CD4 counts in the normal range WITHOUT meds and others, like myself, have been recently infected (less than 1 year) and have low CD4 counts. My 2 readings so far were 296, then 329 with CD% 37 then 27(also confusing to see this % drop). How do we know if my CD4 might be fine without therapy at this point or should I take my Doctors advice and start meds?

Response from Dr. Holodniy

Yes, unfortunately, everyone infected is affected differently, and we don't have the answer yet that will predict who will be able to contain the virus without meds and who will not. In your case, I would need a little more information, such as what your viral loads are doing and likely another set of numbers. I agree that the percent drop is confusing and out of proportion to the very minimal CD4 change. If your CD4 count is truly around 300 and 25% then I would consider starting HIV meds.

That is a significant jump in viral load and could signify that your CD4% drop is a real one. I still think I would need to see another set of numbers to better understand what the trend is.