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Virus Replication Capacity
May 27, 2005

I was diagnosed HIV+ in 2/2005 and had three labs since. My CD4 are always around 300's, 23% and VL stays around 10,000. I just had my resistance test coming back and they also messured the Virus Replication Capacity (RC)> THe RC came back with 56% and my doctor told me that this is an indicator, that I probably won't need medication within the next few years, possibly never. With my CD4's being in the 300s I find that a bit to optimistic. What is your input? Is a 56% RC really an indicator for slower progression? Doesn't a low CD4 count in the 300's contradict this statement?

Thanks to all you guys for spending your time on here to give answers to us positive people. :)

Response from Dr. Young

Thanks for your post.

Replication capacity is a newer technology from the folks at Virologic. The measure is way of attempting to assess how fit a patient's HIV is and how likely it is to cause pathology. A growing body of evidence suggests that RC independently correlates with CD4 cell decline and level of viral load; indeed in one study correlates with risk of AIDS progression. Having a lower RC does not mean that CD4 progression won't happen (as you suggest), but only that on average, your rate is slower than if the RC were higher.

In your case a RC of 56% suggests that you'll have a somewhat lower rate of CD4 decline (in the absence of treatment). I agree with you that it might be a bit optimistic to say that you won't need medications for years (I'd also assert that "never" is way too optimistic), but optimism can't be all bad; you do have a lower viral load which also (and independently) predicts slower decline.

Either way, it sounds like you and your doctor are applying the best technologies and monitoring to your specific clinical situation. This bodes well for your prognosis.

Good luck, thanks for reading. BY



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