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"Fishy" labs?

Apr 26, 2007

I was diagnosed in December of 06, but was symptomatic from July of 06 (sore throat, sinus infections, gut issues).

12/11/06 = CD4 336/19% 02/05/07 = CD4 445/19% 03/29/07 = CD4 364/19%

Variable absolute, but consistant percentage.

The issue is my Viral Load:

12/11/06 = 260800 02/05/07 = 360000 03/29/07 = 780000

My last previous HIV test was 2002, so exposure could have been anytime in that period, but my best guess was that it was most likely March 2006. I was originally hopeful that I was just going through a really long "acute" phase, and that before the 3rd labs my VL would drop an order of magnitude and I would enter a period of clinical latency. My thinking was that because I had a series of immunizations for some international travel in January of 07 that could have caused the Feb VL labs to be higher. But after having my VL almost double in the third labs, I'm no longer confident in anything...

I know that so much of "progression" is variable to the individual, but I don't find any "charts" that shows this kind of consistently midrange CD4 while the VL continues to double each six weeks. Especially when the longest that I could have been infected is four years.

Is something "fishy" here, or are my numbers within the realm of those you have seen other patients experience?

Response from Dr. Wohl

The viral load test results are all basically showing the same level of HIV in the blood. While the numbers seem vastly different, the way the test is done produces quite a bit of variability in the results.

So, a single tube of your blood could be tested three times in one day and the results for each run could be 260,000, 360,000 and 780,000. There is that much wiggle room in teh test. Differences of three fold or more are more likely to be clinically significant and certainly changes of ten fold or higher are.

Your viral load is high. This may mean that your CD4 cell count is expected to decline more swiftly than if your viral load was very low - although we are learning this is not absolute.

As far as treatment goes, in my practice I would be talking with you about starting meds now.


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