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Is my initial CD4 count artificially low because of severe acute HIV infection

Aug 19, 2012

Infected in May (I know exactly when) and had tested neg in April, 2012 and Dec 2011 so I know it's a recent infection. Massively sick July 3-13, got a bit better, then awful night sweats from July 24-31. I assume this is acute HIV and my experience sounds worse than most.

Diagnosed HIV+ on 7/24. I had my initial blood work done on 7/30 and all good news except viral load around 775,000 and CD4 at 381. Is my CD4 artificially low because of the acute HIV phase? Any chance it will go up to a higher "set point"?

I am a 39 yo (otherwise) healthy male. I would like to put off meds until November (or later) to sort out my life, but if my infection is this bad I'm inclined to start right away.

Response from Dr. Holodniy

Given your history of prior negative HIV tests, this does sound like acute HIV infection. It is likely that your lower CD4 count and high viral load are the result of acute infection, and you could see an improvement in your CD4 count and viral load as your immune system gets some control of the infection. I think I would get another set of numbers before November to see where the trend is going. If your numbers are better say next month, then you can afford to wait. If however your numbers are the same or worse, I would recommend starting HIV treatment sooner rather than later.

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