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Numbers in early infection
Feb 9, 2005

I found out beginning of December 2004 that I am HIV positive. T-cell 295 viral load 2356, had a flu-like cold at the time, so we took numbers again on 1/28/2005 T-cell 273 (have read not a statistically significant change) BUT viral load at 26,000. My doctor seems to think this indicates a recent infection and that the flu-like cold in early Decemeber may have been a sero-conversion illness and I have read where the t-cells can plummet in the early stages while the body adjusts. I am in excellent health otherwise, have actually been gaining weight via a new work-out regimen, and have incorporated some changes to my diet, with more to come. How many measurements of t-cells and viral load do we take in order to determine when to start ? It seems like I should start very soon, but if it was a recent infection and the numbers do vary widely at the outset, should I get 2 or 3 more sets of numbers over the next 6 to 9 months ?

Response from Dr. Young

Thanks for your post.

I typically monitor HIV viral loads and CD4 counts every 3- to 4 months. Using this mathematics, getting 2 or 3 more sets of labs in the next 9 months would actually be right on schedule, irrespective of the decision about starting medications.

I do like to have at least two sets of labs to confirm lab values that indicate starting on medications, just to be sure. That said, you already have two sets of CD4 cell counts that are well within the usual threshold for starting medications, your viral load has varied somewhat, but when I see patients with counts that are below 300, it's the CD4 cell count, and not the viral load that dictates the timing of starting medications.

I hope this helps to answer your questions. Thanks for reading. BY



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