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Understanding it all
Jun 29, 2013

Hello.

I recently found out I am infected through a finger-prick anti-body test. I went directly to a specialist for blood work and a confirmatory test.

When I went back to the specialist for results, they were rather interesting.

It turns out that my cd4 count is extremely high, over 1400. My doctor says however that this can change very rapidly and in a few months it could be down to 300 or below. He said this speaking in general, not because of anything specific to my personal situation.

My viral load was a little over 10,000.

I realized after the appointment that we never discussed the confirmatory test itself, specifically the Western Blot, which I have read is pretty definitive when paired with a positive anti-body test.

Does the fact that I have a viral load at all confirm that I am positive and make discussion of the Western Blot unnecessary?

Also, though not extremely high, does the fact that I have a far from undetectable viral load disqualify the possibility that I could be an elite controller/long term non-progressor?

Finally, what reasons could there be (either good or bad) for my t-cell count to be so much higher than even the average uninfected person?

The specialist I am working is self-proclaimed as "very aggressive" when treating HIV. My general sensibility is in line with this as I feel its better to nip something in the bud than wait for it to get really bad.

Coupled with all of this, I have two other underlying health issues that I have been dealing with for years:

1.) I have a prolonged QT for which I take Nadolol 2.) I always have slightly elevated liver enzymes

I just wonder if in light of all of this, treatment would be a good choice right now?

Response from Dr. Holodniy

Yes you are infected and almost all cases the elite controllers have undetectable or extremely low viral loads, which yours is not. With regards to CD4 counts the normal range is 500-1500, so yours is in the normal range. The decision to start treatment has changed over time, with experts now suggesting people start treatment when diagnosed, regardless of the CD4 count. Your current other health issues would not exclude starting HIV treatment now.



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