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Pregnant - Initial pre-treatment lab results

Oct 7, 2012

My wife is 13 weeks pregnant and was just diagnosed HIV positive when tested at 8 weeks. I am HIV negative. We do not know for sure, but we think she was infected some time 3-5 years ago.

At week 10 she broke out with shingles, which is uncommon but not unheard of in pregnancy. Anecdotal evidence - a survey of friends with kids - showed 2 friends had gotten shingles while pregnant and I presume they are HIV negative. Anyway, my wife took a 7 day cycle of antivirals until week 12. At week 13, 7 days after finishing, she gave blood for her initial pre-treatment CD4 and viral load.

The results were CD4 count of 374, CD4% of 30%, and viral load of 7,000. We are seeing the ID specialist in 2 weeks. Obviously, she will start meds immediately because she is pregnant. I am just wondering how to interpret the results given: ~4 years of infection, CD4 lowered naturally by pregnancy, affect of shingles and shingles meds, etc. As far as the progression of the virus, is she in relatively OK shape for someone infected this length of time?


Response from Dr. Holodniy

Pregnancy and an acute infection like shingles can both independently cause changes in CD4 count/percent and viral load. Repeating the counts in 2 weeks prior to starting HIV meds might give you a better chance in determining what her "baseline" counts are. However, given that her viral load is relatively low, and her CD4 percent is in the normal range, HIV treatment will get her to an undetectable viral load pretty quickly and you will see the CD4 count likely increase to > 500 relatively quickly, which is also in the normal range.

yellow fever vaccination under Atripla and possible VL spike

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