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Virus: Spreading like Wildfire
Oct 22, 2003

My partner tested positive for HIV April 2003 and I test negative. On May 30, 2003 I tested positive. A month later I saw a Infectious Disease specialist and my numbers were good (CD4= 609 and Viral Load= 22,000). Three months later (October 21,2003) I went in for my second appointment and my number had changed dramatically (CD4 = 487 and my Viral Load = over 100,000). The Viral Load results came back as Great than 100,000 which was pretty shocking to say the least. I am going in for more blood work to get the specific count. My doctor has decided to put me on meds (Combivir and Sustiva). My question at long last.... can a Viral Load go down? I know that CD4 can fluctuate, but what about Viral Load counts? I appreciate your advice and support. JD in Long Beach

Response from Dr. Young

Thanks for your question.

Like CD4 cells counts, HIV viral loads also vary from day to day-- as much as a five-fold change can occur without any real medical significance. From this, you could see that one day's viral load of 25,000 could easily be the next day's 100,000.

What we try to do in assessing the health of someone with HIV is to average a couple of baseline values (if there is disagreement between values) or to look at trends.

In the end, on therapy with ZDV/3TC/efavirenz (Sustiva), your viral load should respond very well to therapy. Make sure that you get follow up viral load testing-- I like to see levels reach <400 copies at least by 12 weeks, if not a lot sooner.

Good luck, thanks for reading. BY

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