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Things that make me worried
Mar 18, 2012

Dear Sir/Madam,

I was diagnozed in January 2012, infected in Q2-Q4 2011. My VN is 147,000 CD4 472, all blood tests are optimal for my age (25). I am MSM, living in the EU with access to free high-level health care. No other co-infections, in good shape, no health problems whatsoever, no drug user but I do smoke. If my next results in April show high VN again, my doctor wants to start the treatment which I think is a good idea.

I would like to ask about two things that make me worried:

1. If my VN after approximately 6 months after infection remains that high, does it mean that I am "fast progressor" or my virus mutation is more aggresive than what is usual?

2. In case I start the treatment and I follow it strictly, what health issues should I be worried about? What are the risks of having treatment failure/multi-resistant mutationof the virus? Can I even consider myself the "lucky guy" from British statistics saying I can easily make it to my 70s?

I just met a very nice HIV- boy who likes me nevertheless my current condition but before I get involved with him, I would like to have these questions at least partially clarified...

Thank you very much for your time

Response from Dr. Holodniy

If left as an untreated condition for months to years, yes, people with viral loads > 100,000 copies/mL will progress faster (high CD4 declines) than those with viral loads < 100,000. that is why current treatment guidelines suggest treating people with viral loads > 100,000 regardless of the CD4 count, even if it is in the normal range. In general, in those people without other major medical conditions who start HIV treatment early and control the viral infection and preserve immune function, there should be no reason why you won't be collecting a pension when you are 70. If HIV is taken out of the equation, then as one ages, other medical conditions (heart disease, cancers, etc) begin to show up. Although some of these medical conditions occur with greater frequency in those with HIV infection, with appropriate medical care they can be prevented or detected earlier to reduce any problems. As long as the viral load remains undetectable, the risk of resistance is extremely low.



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