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Understand how this goes?
Jun 20, 2004

Hi, I am a 26 year old male and on December 13, 2003 I got the dreaded news that I have HIV. I been going to follow up treatment and have learned the golden rule " T-cells up good, Viral Load down good." My first blood test wich was in Feb. was CD4+ (or T-Cell) 787 and Viral load (VL) 22,100. At that, my doctor assured me that was good. Then,told me that I did not need medication since my VL was not at 55,000 and that my T-cell count was not no where near 300. My second visit (six months after) was CD4+ 626 and VL 6,260. Then my doctor told me that my body was fighting the infection and that my T-Cell was still in a good range, and once again I did not need medication again. Now heres the question, she then made my next appointment for 3 months instead of six months as before, is somthing wrong? I getting pertty scared thinking that my virus is progessing in a rapid rate that my doctor is uncertain about? And my T-Cell count has dropped 161 within a 6 month rage, is this normal, should I be loosing that much T-Cells within a 6 month range? Since my body is fighting the infection my next question is, isn't there a chance that the virus is starting to hide and thats why im getting a low VL? I left the office uneased I don't really know what is the righ number to loose within 6 months, I asked and got an ansewer that really thought I understood but thinking about I really don't. I try to take care of myself workout and I have a slight addiction to smoking, ciggeretts that is, lol! How much does smoking affect immune system? With my numbers as so, how would medication get along with my body? Everytime I give a blood test will it say if i have one strngs or two? What are your point of view of getting a doctor with a history of treating this virus as opposed to a doctor that has been treating it since 1998. Also, im having insurance problems is there anywhere I turn? I live in Texas and it's hard to find good solid resources here, or I don't know about them. Well I think that is pertty much my question, I am so glad that there is a place to get ansewers, I give this site it props, I have read numerous quesiton and have informed and educated myslef here. Thank you to all. p.s. sorry for so many question, and about the spelling

Response from Dr. Holodniy

Both sets of values do not indicate any trouble in my mind. The standard of care is to follow patients quarterly and obtain CD4 counts and viral load at each visit. There will be variation in CD4 counts and viral load levels, particularly in those patients with relatively high CD4 counts. CD4 counts can vary just by time of day they are drawn (lower in the morning, higher in the afternoon). Other ongoing infections, recreational drug use, immunizations, to name a few things, can affect CD4 counts. The CD4 percentage is a much more stable number over time and thus, should be followed as well. The variability in viral load can vary up to 3 times a values. Thus, although this looks like a significant change, is about within assay variability.


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