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Do I need to continue medication?
Mar 23, 2014

I had a negative HIV test in November 2013 and a positive test a month later in late December 2013. The second week of December I had acute retroviral infection (flu-like symptoms), in other words, I seroconverted.

My first labs done on 1/9/14 indicated CD4 of 557, CD4% was 25.3%, VL=9840. I was referred to an infectious disease doctor who did another set of labs as well as resistance testing two weeks later on 1/22/14 and my VL was 1060, CD4 of 583 and CD4% was 28%. He started me on Kaletra and Truvada on 1/22 and when the results came, almost 2 weeks later, he switched me to Complera which I have been taking ever since.

During my appointment on 1/22 the doctor said that I am likely a long term non-progress or elite controller because my VL was only 9480 and dropped to 1060 in 2 weeks prior to starting medication.

My last test on 2/26/14 shows my VL=30, and CD4 of 614, CD4%32.3 and my doctor said that 30 is not undetectable because the test that the lab used detects a VL of 20 or more. He recommended I keep taking Complera for at least a year before stopping the medication to see how my body would respond on its own. He said that if there was a potential cure that I would be a candidate because the reservoir of infection in my system is low (not sure what he meant by this, but ok).

My concern is that it seems like my body was well on its way to controlling the infection prior to starting meds and my VL would have more than likely continued to drop to where it is at now (VL=30) without any medication; although now we can't be 100% certain since I did start medication a month ago. Do you think I should continue on the medication or stop now and see how my body controls the infection on its own or, as my doctor recommended, continue for a year then stop and see how I respond? What are the pros and cons of finding out now or in a year? My resistance testing shows that I was not resistant to any HIV meds and I have not had any side effects thus far.

My other labs from 2/26/14 are as follows:

Absolute CD8 Suppressor = 952/uL (out of range). Expected range 109-897 uL %CD 8 Pos. Lymph. = 50.1 (out of range). Expected range 12.0-35.5 %CD 3 Pos. Lymph.= 82%. Expected range 57.5-86.2% WBC = 4.3. Expected range 3.4-10.8 RBC = 4.91. Expected range 4.14-5.80 AST = 43 ALT = 89 CD4/CD8 Ratio =0.64 (out of range). Expected range 0.92-3.72

Response from Dr. Holodniy

Although much of what your doctor said has some plausibility, my recommendation would be to continue taking HIV medications to preserve immune function.



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