Doctor, I have just recently found out that I am HIV+. Initially through a saliva test I was given to increas my life insurance. I received a positive, and went to my PCP to have all the initial HIV tests, Hepatitis, and CD4 count. The HIV test came back positive.I am now seeing a specialist in Lexington,KY.My viral load is 353,000 and my CD4 is 390. My question is, according to all I have read, I should be sick. But I am not(I am totally asymptomatic),and would not have been aware if I had not went to get this increase on my life insurance. Any insight?I am now on epivir, 300mg bid;retroivir, 600mg bid;and viramune,400mg bid. I am really confused an concerned about these numbers. I am a 29yo w male , possibly infected up to two years ago. I have been absinent for the last year. Any insight? CLM, KY

In general most people with a CD4 count of 390 have few if any symptoms. However with a viral load of 353,000, your CD4 count would have gotten much lower had you not started therapy (because of high levels of virus replication causing destruction of CD4 cells)and then you would begin to have symptoms. The therapy you started will increase your CD4 cells by 100 or more and should bring your virus levels down to 1,000 or less. Please check that your doses are correct. The doses you cite are the total daily dose for each of those drugs, not what you should get bid. You may have toxicities or side effects with the high doses you state. MH