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Terrified--please help

Apr 13, 2003

Dr Wohl:

I tested neg last March, and tested positive this March. My first labs showed tcells of 340 and vl of 350,000. I had another test 3 weeks later (4-1) whch showed tcels of 350 and vl of 544,000. The lab also does not believe I was infected w/i the past 6 months (based on a special test they did).

1. Is this a normal increase in vl?

2. Could this increase be caused by an infection (i was getting treatment for giardia during the first test, had a tetanus shot 2 weeks before the first test, have a toothache now, had hep b vaccine for 2d time with last of three shots on dec 20,2002).

3. Could my tcells and vl ever improve w/o meds? I really prefer not to go on them just yet--being I just seroconverted one year ago!!

Please help. Kevin


Response from Dr. Wohl

Dear Kevin,

There is some degree of variability to all lab tests and biological measures, for example, your temperature is changes during the day, as does your heart rate and blood pressure.

Your T-cells and viral load also ebb and flow. Added to this natural rhythm is the variability of the tests themselves.

There is virtually no difference between a T-cell count of 350 and 340. Likewise, the viral load test has a built in three fold variability (the same blood tested again the same day can give a result three fold different than the original test result). So again, there is unlikely any difference between a viral load of 350,000 and 544,000.

Now, all that said there are things that can impact the viral load and you names a couple of major ones: vaccinations and concurrent illness. These can transiently raise the HIV viral load.

To me it sounds like your numbers are stable. I'd continue to follow them and hold off on therapy right now given your apprehension. Eat well, take good care of yourself, don't give the virus to anyone else and see your doctor regularly - these will help keep your counts going in the right direction. DW


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