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Recent infection, low viral load, ?prognosis
Jul 28, 2000

Dr. Holodniy,

Excellent forum, I find it very informative. My question is this: I have a friend who recently seroconverted (HIV Ab neg in May, then pos in July) whose first viral load was 6,000 and CD4 380. Is this a typical VL so early in infection (mine was 120,000 at a similar time after infection), does it imply yet a low viral set-point, and if so does it have implications for prognosis or deciding for/against early antiretroviral therapy?

Thank you.

Response from Dr. Holodniy

It appears at first glance that your friend does have a lower setpoint. This does indeed have implications for prognosis. In the absence of therapy, a person with this viral load generally would have a low to moderate risk of progression. In other words a 25% chance of developing AIDS in 5-10 years. The 2000 guidelines for treatment would put such a person in a category of where treatment could be deferred or offered at this point. If treatment is deferred, the numbers have to be followed closely.

MH



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