Am I a Long Term Non-Progressor?
Jun 22, 2014
I was diagnosed in 2004. not on any meds. viral load is now at 1200. at one point it was 5,000.. highest i think was 7000 years ago. percentage is 28.6 and CD4 is 490. It has moved up and down but the lowest it has been was 326. percentage lowest was 24. This is 10 years later and my present numbers are as described: VL: 1200 CD4:490 and %:28.6. What does this mean? Some doctors say I should consider meds, my primary doctor agrees with me that it is not necessary. I am asymtomatic. What would you recommend> What does this mean?
Response from Dr. Holodniy
In general, people who are nonprogressors have stable and usually normal CD4 counts and percents with very low or undetectable viral loads for an extended period of years. Another term is elite controllers, but such people usually have undetectable viral loads in the absence of HIV treatment. This means that the immune system is doing a good job of controlling the infection on its own. In your case, you still have a detectable viral load and mild decrease in both CD4 count and percent from normal. This indicates the virus is replicating and that your immune system is not completely controlling the situation. This level of replication and ongoing inflammation could result in other downstream consequences such as premature heart disease. There is no urgency to start HIV meds, and your doctor is correct at one level, given your longevity with infection that starting HIV meds may not be necessary, but experts would likely agree that controlling the infection further with HIV treatment would be advisable.
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