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CD4, Viral load, Oral Thrush

Oct 29, 2017

Hi Dr, during serocoversion does CD4 count plummet drastically due to HIV infection? During my serocoversion I tested and my CD4 count was 272 I suspect after only a month after infection? At worst case, I could have been infected four months earlier before diagnosis. Is it normal for T-cells to drop to such levels after 1 month or 4 months after infection? I also had oral thrush (individual patches back of throat), is this AIDS defining or HIV considering my cells were 272 upon infection? Lastly, started treatment shortly after (tribuss/trivenz) and managed to reach UD successfully and T-cells rose to 995 but dropped during second bi-annual screening to 650+ and viral load went to 80 copies. I never stopped treatment but did miss approximately 6 days (not consecutively) since treatment. I am adherent but due to current unemployment I have not done any screening but still takes meds every day (trivenz). I am 25+ and have been positive for 3 years now... Please answer... I am also finding it difficult to put on weight except on my stomach and have slimmer legs now (is it the meds?)...

Response from Dr. Holodniy

Yes, CD4 counts can decrease to that level during acute infection. Thrush would be an indication of altered immune status, but it does not necessarily indicate AIDS, and your CD4 count was not < 200, which would represent an AIDS diagnosis. It is always difficult to determine when infection may have occurred. Although you don't indicate why your previous and current weight is, it is unlikely that the HIV meds are the cause. You don't indicate what your current CD4 count and HIV viral load results are. Is your viral load now undetectable again?

Confused with Hep B results.
CD8 count is always higher than CD4 and CD4/8 ratio less than 1

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