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What are the chances of myself remaining this good?
Sep 6, 2004

Dear Doc, I have had HIV for a year now and have remained very stable. I am 43 years old. My CD4 count is between 802 and 850, and my CD8 count remains in the 400-460 range. I have also been undetectable <50 the entire time, with no blips, and had just completed seroconversion at the time of my first positive test. I have never needed meds and have always been <50. All I seem to have are the antibodies, the same situation if my body defeated any other virus. It is almost like I am vacinated (rare with HIV but there is a first for everything!). My CD4 percentage remains 40-50% and my CD8, 20%. My doctors have said that by looking at my bloodwork, if they didn't know I was positive, they would think there is nothing wrong with me. I am being studied by the Aaron Diamond project, and also have a great personal doctor who is a specialist. They all say my situation is very rare, and my unusal percectages, even more rare. They state that my low stable cd8 count/stable percentage is an indication that the virus is not replicating, would you agree? Since most people in my situation have inverted ratios, mine has never been inverted, and has been in the high normal range from day one, is it an indication it is not replicating in other areas, other than my blood? My doctors seem to believe that my body isn't detecting any antigen which is very good news. If it detected an antigen, my CD8's would be much higher I was told. Have you heard of others as lucky as myself, who remained stable, with my normal percentages, with no viral blips forever? Thanks, David

Response from Dr. Young

Thanks for your post, moreover, thank you for volunteering your time at the Aaron Diamond Center. You've got some of the world's most respected doctors and researchers there (indeed, they're likely to be more up to date on the topic that you've asked than I).

Yes, your situation is very unusual-- well less than 1% of persons infected with HIV. If there is any viral replication going on in your body, it must be doing it at extremely low levels.

That said, forever is a very long time; I've had two patients in my career that were like you (with undetectable viral loads, but infected for years) who had very slow declines in their CD4 counts. One eventually had his viral load become intermittently detectable and had his CD4 count drop to below 300-- prompting treatment. Either way, yours seems like a very fortunate situation and I don't expect any significant drop in your immune function for a very, very long time.

Thanks for reading. BY



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