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Long term non-progresser with high VL?
Aug 31, 2005

Hi guys, Any chance of being a long term non-progresser with a high VL? My VL is 750,000+ yet my CD4 stays stable around 600. What gives? Also should one always start on meds with such a high VL? Or should I wait for CD4s to fall? Thanks

Response from Dr. Pierone

Hello and thanks for posting.

There was a very interesting presentation at CROI (AIDS conference) earlier this year that may provide the answer to your question. Here is the link. In a nutshell, the investigators identified a small group of patients who had long-term nonprogression in spite of high viral loads. The distinguishing characteristic was that these patients were infected with virus that had impaired replication capacity (due to a variety of molecular mutations/mechanisms).

This may be what is happening in your situation. It is likely that you don't need to start on medications with a high and stable CD4 cell count. These investigators are from Cleveland, Ohio. To follow up you might consider contacting them and see if they are still studying this topic.



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