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trends of numbers

Apr 7, 2013

Hi Dr Holodniy here is my ? i tested positive for hiv 1 on elisa wb dec 27 2011 had my first follow up jan 19th 2012 initial blood work showed normal cd4 counts 715 38% cd8%532 32% rna showed no virus load undetectable. i never had a risk for hiv infection exp intercourse or iv drug use. but somehow i tested fully positive. i went back in march for more blood work virus load still undetectable cd4 704 36% cd8 649 35%. went for more blood work in may cd4 649 29% cd8 713 %38 rna showed 51 copies hiv. during this time was treated for hypolri or norovirus in stomach which was eradicated after 2x treatment from march to june. in june 2012 i went to see different id doc second opinion blood work showed cd4 800 31% cd8 1196 40%. no rna virus detected. went back to original id doc in sept 2012 cd4 1096 33% cd8 1396 40% rna 38 copies. id doc said do not need meds follow up in six months. since jan started felling stomach problems similar to last dec went for blood work in march cd4 714 25% cd8 1400 49% rna showed 695 copies. i dont know what to make of all this should i be on meds i dont know how i got hiv never had any risk factors at all no drugs married man 2 kids wife is negative conclusive never had any blood accidents tested negative in the past upon blood donation. what bothers me is cd4% fluctuation with low virus load what can be the cause . id doc has no answers some think i dont have hiv . i cant see how but this is my reality. sorry for the long post but i need some advice. thks

Response from Dr. Holodniy

I agree there is a lot of fluctuation in your CD4 count and percent. The HIV viral load results are intermittently low positive and indicate a low level of viral replication in the absence of treatment. On the one hand, your CD4 count/percent are in the normal range and your viral load results are very low; you could argue that HIV treatment is not indicated at this time. On the other hand, you could argue that viral replication is ongoing, albeit at a low level, which is what is contributing to your subtle CD4 cell/percent decline, and therefore HIV treatment could be indicated to shut that replication off and stabilize the the CD4 count/percent.

Just diagnosed / First CD4-VL test
about hcv pcr( qn)

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