Mar 17, 2002
doc.i know we dont know how many t-cells one has before being diagnosed with hiv.my doc says i have been poz for 8 to 10 years and has started me on sustiva and combivir.vl 704.000 cd4 at 240 although i know this is a extreamly high vl shouldent my cd4's be lower? or is it safe to assume that i had alott of t-cells to begin with and they have been fighting all these years and if so will they go back up .thanks
Response from Dr. Young
As you point out, there is difficulty in trying to predict the past based on current lab results. You are correct in the assumption that your CD4's should decline more rapidly than average with a baseline viral load of 700,000.
What we do to estimate time of infection has to do with looking at large populations of persons infected with HIV. Based on this, the average time from infection to an AIDS level of CD4 (200) is between 8 and 10 years. It is also thought that the average baseline viral load is around 50,000. I think I would put your estimate at some time shorter than 8 years, but still for several years.
I don't know of any way that we could estimate the baseline CD4 cell count; this knowledge wouldn't change the opinion to start therapy or when and if we could stop.
Hope this helps, BY
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