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rapid drop in cd4
Jun 20, 2003

hi. ive been reading your site ever since i got my + result. i find it highly informative and want to thank you for your much-appreciated work !!! i am + for about 18 months and my VL/cd4 went from 400000/480 in october02 to 140000/450 in february03 to 104000/330 TODAY. my doctor says we can still wait with the beginning of therapy because the VL is still declining also. i am a little concerned because the cd4 dropped so rapidly. i would appreciate a 2nd opinion from you guys. thank you very much and have a nice weekend ! dirk, 31 cologne germany

Response from Dr. Young

Thank you for your question, Dirk.

I differ with your doctor's statement about your viral load-- we know that viral loads can vary about 5-fold from day to day. From this, the differences between your three sets of labs are probably not significant; furthermore, no matter which number you pick, your viral load is quite high (>100,000 copies). Therefore, using this trend in viral load might be deceptive with regard to recommending therapy.

With a CD4 count about 350 (particularly if it repeats on the next test), most US-based clinicians would recommend considering starting therapy. This decision is not one that needs to be rushed, but one that I would endorse.

Good luck. BY

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