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Sharp Drop in CD4 count
Aug 5, 2012

Hi Doc!

I had some concerns about my recent lab reports. I will just give you the background on my numbers. I was diagnosed in December 2010 and have not started taking meds yet.

27/12/2010 - CD4 Absolute 679, CD4% 42, VL: HIV-I RNA Quantification 1,648 IU/ml, Log Value 3.21

26/03/2011 - CD4 Absolute 494, CD4% 29, VL: HIV-I RNA Quantification 2,836 IU/ml, Log value 3.45

01/07/2011 - CD4 Absolute 470, VL 340 copies/ml

14/12/2011 - CD4 Absolute 581, CD4% 27 VL: HIV-I RNA Quantification 483 copies/ml, Log value 2.68

05/07/2012 - CD4 Absolute 372, CD4% 27 VL: HIV-I RNA Quantification 1409 copies/ml, Log value 3.14

As you can make out doc my cd4 absolute and percentage fell sharply after my first test and have not really gone back to the same level. Before I was diagnosed in December 2010 I was tested in June 2010 and was negative at the time.

During my third test on 01/07/2011 I was also diagnosed with Chlamydia and was given a weeks dose of Doxycycline. My CD4 Absolute count in the subsequent test went up to 581, although my CD4% declined a bit and my Viral Load increased.

My latest test is what is causing me some distress. My CD4 Absolute count has dipped to 372. My CD4% has remained at 27% but my viral load has increased to 1409 copies from 483 copies.

I am 27 yrs old, a gay south asian man and I have not been sick nor do I have any other alarming symptoms. I just feel a bit tired every now and then but besides that have been keeping healthy. I exercise every day and do weight training at the gym at least 4 times a week.

Is it normal for the virus to start doing so much damage this soon after diagnoses? I thought after the initial infection the numbers do drop but tend to bounce back up after the bodys immune system kicks in and starts to fight the virus. My viral load is still not very high but my CD4 absolute count and CD4% dropping much faster than the rate my viral load is increasing. Why do you think that is happening? Is it normal?

I know I should now seriously contemplate going on the meds before any more damage is done. Its the thought of taking the meds every day for the rest of my life and some of the horror stories that one reads on the internet about the side effects of the meds that I find rather daunting. But I guess one just has to take that plunge sooner than later.

Please do let me know your insights about my test results so far as I am extremely worried.

Response from Dr. Holodniy

Getting the diagnosis, doesn't necessarily mean that is when infection occurred. Infection may have occurred earlier than 2010, and so the virus may have already had time to be doing damage. Your numbers are not too bad, however, my recommendation would be to start HIV treatment.



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