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viral load tests
Oct 4, 2000

Dear Doc,

I have just been diagnosed hiv pos, July 6 2000. My first viral load and cd4 tests were 271,000/262, using a 1st generation pcr test. My second tests used a 2nd generation pcr test, vl was 25,500 and cd4 was 230. What is the difference between these 2 tests? I started meds, sustiva, d4t, and 3tc. Reading other questions I don"t think I want to remain on the d4t due to fat redistribution, would it be alright to switch to combivir this early, to avoid this problem. Am tolerating meds very well. Get retested in 3 weeks and see doc in 5 weeks. Thanx :-)

Response from Dr. Hellerstein

It is hard to make a specific recommendation from a distance -- this is best left between you and your doctor.

The difference between the 2 tests is probably real, not due to the tests themselves -- i.e. either you were in acute HIV infection, and your body controlled the virus a bit on its own, or you had started antiviral therapy in the meantime, or something else happened in between. In any case, the key is not a single test result here and there, but the trend over time.

So you do need to be seen again by your doctor. The questions regarding best regimen have to be individualized.

Best of luck,

mh


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