Dear Doc,

I was diagnosed hiv pos 07/06/00, got 1 v.l. and cd4 test 1 week later, v.l. 271,000 and cd4 262, using 1st generation pcr test. 2nd test 17 days later, using 2nd generation test, still NOT on meds, v.l. was 25,500 and cd4 was 230. 2 questions, what is the difference between the 2 tests, and how can the viral load be so much lower in 2 weeks, and cd4 be lower, without meds? I have started taking Sustiva, Zerit, and Epivir, and get tested again in 3 weeks. Thanx :-)

Not sure about the generation issue. Shouldn't be that kind of difference between tests just based on the generation, or even a different kind of viral load test. Two other possibilities. If you were acutely infected, then the two tests could have caught you on the way down while antibodies were developing. Or if you were chronically infected for some period of time and didn't know it, and you had some sort of other acute infection during the first viral load test, from which you were recovering during the second test, that could explain the difference.

MH