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timeframe
May 12, 2002

At approximately 6-7 years of infection is a cd4 of 450 and vl of 44000 the norm? I've seen alot of different people (Hiver's)quote these numbers and wonder if this is considered low ,high or average progression?Would this call for agressive treatment?

Response from Dr. Young

There is a lot of variation in CD4 counts and viral loads-- these translate to differences in the rates of progression of HIV disease.

An average viral load is about 50,000 copies/mL, hence 44,000 would be considered pretty average. As for your CD4 count of 450-- this remains in the normal range (>350 cells). It would seem to me that these numbers would predict an average rate of disease progression.

In my view, all treatments should be aggressive and potent, once initiated. Typically this means a three- or four-drug regimen. The key question is when to initiate such therapy (this is the subject of many other questions that you can review in this forum).

Agressive medical care (ie., treatment) would also include careful laboratory monitoring of viral load and CD4 count evaluation and vaccination for hepatitis, pneumococcus, influenza, counsel about preventive medicine (smoking, drug use, safe sex, guns) and mental health. Indeed, there is a common misconception that the only treatment for HIV involves antiretroviral medications; the later is simply to remind us that there is much more to care than just drugs.

Hope this is helpful, BY


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