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No Viral Load
Mar 27, 2007

I'VE BEEN HIV FOR TWELVE YEARS NOW. CD4 COUNT IS AT 492 WITH AN UNDETECTABLE VIRAL LOAD. EVERY SIX MONTHS I DO A CHECK-UP. MY DOC DOESN'T KNOW WHAT TO DO WITH ME. HE SAIDS MY CASE IS RARE. MY QUESTION IS WHAT SHOULD I DO AT THIS POINT ? WHEN SHOULD I START ON MEDS? THANKS

Response from Dr. Young

Thank you for your post.

Your's is a unusual circumstance that affects ~1% of HIV+ persons. Having an undetectable HIV viral load (but confirmed positive antibody test) suggests that your immune system is doing a quite good job in controlling HIV reproduction. This doesn't necessarily mean that HIV can't cause immune system damage or symptoms, but rather that they are generally less common and less severe- if they occur.

As long as your not experiencing any HIV-related symptoms, all that needs to be done is continued laboratory monitoring (as well as the usual preventive medicine stuff that we talk about here from time to time). Some persons in your situation can have slow deterioration in their CD4 counts-- in this circumstance, starting HIV medications is indicated with the same general guidelines that we use for patients with detectable HIV viral loads-- when counts go less than 350 or when symptoms related to HIV occur.

Hope this helps. BY



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