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Up and down CD4 and Viral loads results!!
Jan 24, 2006

How are you doing Dr. I am a 32 y/o African American male in Florida. I was dianosed w/ HIV in March 2004. I am not currently on meds and my cd4 and viral loads have been up and down (ranging from cd4 525 to 324 and my vl 100,000 to 3700. My question is this. I believe the time is drawing near for me to commence meds. My results in Dec. was cd4= 354 and vl 20,000. We took a second test two weeks later and my cd4 was 491 and vl 50,000. At this point I surely thought it was time for me to start my meds. However, the Dr. wanted to take one more test, due to the fact that I had an eye infection during my aforementioned 2nd test. So that leads me to this month. My mose recent results 1/10/2006 are cd4 324 and vl 3714. So again we are somewhat at a stand still. My cd4 has dropped but so has my vl. My dr. wants to do yet one more test before placing me on meds to see if my cd4 will rise, which it has before. What is your professional opinion on this situation? Looking foward to a speedy reply. Thanks.

Paul in Fla.

Response from Dr. Young

Paul, thanks for your post.

If your 2nd CD4 count was taken during an acute infection (eye infection), I'd discard these values from consideration. Doing this, then your 2 "valid" CD4 counts are 354 and 324-- very similar numbers and in the range to consider treatment. I wouldn't use your viral load as a single parameter to start or not start-- it's merely a prediction of how rapidly your CD4s might decline.

So, if you were my patient, two CD4s that meet the consensus for when to start provide sufficient basis to recommend treatment. This doesn't mean that you must start today or tomorrow, but I'd be thinking about treatment in the relatively near-term.

Hope this helps, BY

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