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9 million viral load initial infection stage - what does it really mean?

Aug 21, 2011

I have a 9 million viral load at initial infection stage - what does it really mean? My CD4 was then 161. 2 months later, it went up to 300. My doc in Singapore decided to check on my CD4 in 3 months time to see if there is any further increase, therefore he decided I should not start meds yet.

However, I was told that a high viral load could mean that I have caught a more virulent strain of HIV and that it could be more resistant to HIV medicine... Could you enlighten me on this? I am understandably concerned.

Response from Dr. Holodniy

That is a very high viral load, and is usually seen during acute infection. The marked reduction in CD4 count, with recovery, as the your immune system begins to gain some control, can also be seen during acute infection. Your doctor's plan is not unreasonable, as it is likely given the CD4 count trend, the viral load will drop significantly in a couple of months. It is difficult to predict where your CD4 count and viral load will stabilize at. This is usually referred to as the set point. But if the viral load remains above 100,000 or more 6 months after infection, many experts would suggest starting HIV treatment regardless of where the CD4 count is (normal range 500-1500 in uninfected people).

Re: Should I ask doctor to change treatment plan?
Should I start meds 1.5 years after infection?

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