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CD4 and HIV RNA Test Results

Jul 21, 2013

Hi, I was diagnosed with HIV in June 2012 (contracted the virus in the summer of 2011) and started treatment (Truvada+Kaletra) immediately as my CD4 was 151 (10%) and my viral load was 341,000. In a few months, I had a CD4 of 302 (16%) and undetectable (negative RNA) viral load. Then in March 2013, my CD4 was 654 (19.8%) and RNA test result came inconclusive due to eritrosit in blood samples. Now my CD4 stands at 403 (14.75%) and my HIV RNA is less than 261. I called my doctor just then and she said: it is all good and not to worry. She suspected lab error or a mix-up with CD4 results as another of her patient had a 6 month treatment break and his CD4 is 52% and it was much less before. I also called the hospital where the HIV RNA test is done, I was told <261 means something like between 0 and 261 (so slightly positive) and if it was negative it would be 0. But as far as I know there are machines that can not detect below 20 - 50 or 400 and not zero.. I am now trying to understand what this 'less than 261' means and why 261, couldn't come across anything on Google and why my CD4% would go down by 5% in 3 months. I was very afraid (and I still am a little) of drug resistance or superinfection. Before my current test results I also decided to switch to Truvada+ Stocrin from Kaletra as I do not like taking 5 pills twice a day and my bad cholesterol levels have been going up and my body fat percentage went up due to PI- Kaletra even though I have been exercising very hard and eating well. I will start taking Stocrin+Truvada today. Thanks for your help.

Response from Dr. Holodniy

I am not aware of any HIV viral load tests with a lower level of detection at 261 copies/mL. This does not make sense. You are correct regarding viral load detection limits in various assays. Given that result, it is difficult to know where you stand, and whether the reduction in CD4% is real or because of a lab mixup. An repeat CD4 count/percent and HIV viral load is definitely in order here.

CD 4 count viral load

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