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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.


Viral load and CDC reporting
cd4 increase but cd4/cd8 ratio decrease

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