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Trends in my labs - your opinion?
Sep 28, 2004

Hello Doctor.

I was wondering if I could get your opinion on my lab results.

My numbers are: 12/2003: 502/304179/20% 01/2004: 468/264000/24% 04/2004: 489/154000/24% 07/2004: 456/71300/19%

I have not yet started meds. I'm male, 42, don't smoke, don't drink, and get aerobic exercise. Except for some enlarged lymph nodes (gone now), I've not had any symptoms. Aside from the HIV, I'm in great health. I was diagnosed HIV positive 12/2003, but I'm not sure how long I've had it (it was my first HIV test).

Is this good news that my body is knocking down the viral load, or is the decrease not very significant? It's basically dropping by half every 3 months! If the VL decrease continues, do you think I'll start to see my CD4 increasing at some point? If not, do you have any guess as to when you think my CD4 count will drop to the point where I will need meds?

Any other observations you can make based on this info will be appreciated!

Response from Dr. Pierone

This is certainly good news that your viral load is trending lower. One potential explanation might be that that you were recently infected. Following primary HIV infection the viral load will sometimes progressively decline until a set point is reached. It is possible that the CD4 count will increase, but just as likely that there will be a gradual decline over the coming years. It is probably too early to tell when you will need to start medications since treatment guidelines are a moving target. Also, you may not have reached a plateau in the viral load and this set point is a major determinant of the prognosis. Good luck!

Viramune Truvada first line?
low VL&TCell, when to start meds.

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