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2nd labs:(...thoughts?
Dec 15, 2007

Hi... I just went through seroconversion 31/2 months ago and tested positive just as I was beginning to feel better after a 2 week illness. Shortly thereafter got my 1st labs. CD4 425 Cd4% 21 and viral load 26000

Then I tested three months later and my results

CD4 395 CD4% 20 and VL 34 000

I was disappointed. I'd quit smoking and was working out and taking supplements hoping it would help.

Losing 30 CD4 seems like a big deal. Anyway, my HIV specialist wasn't worried at all. But we did open up a dialogue about meds considering if I lose 30 more I should definitely start.

What would you suggest doctor? I would be interested to hear your opinion.

I think I know I have to just bite the bullet and start taking these drugs but I'm obviously really freaked out about the whole thing.

I also just want to avoid lipo more than anything and my doctor was saying that if one starts when their counts are better then one has a better chance of tolerating them and having less side effects.

Sorry if this is scattered. thanks in advance if you can answer.

Response from Dr. Young

Thanks for your post.

I think that your seriously over reading your labs. A 30 cell change in CD4 counts is meaningless and well within the variability and precision of the test.

Your doctor is right- don't worry at all. He or she is also right that starting therapy with healthier CD4 counts (as opposed to counts below 200) seems to dramatically decrease the risk of developing lipodystrophy.

The thing that troubles me is that I'm not sure that I would or could conclude that you have recently seroconverted. If you were infected 2 weeks before your first set of labs, your viral load should be in the hundreds of thousands, if not millions. Did you have a negative HIV antibody test at this point? Or, was your HIV antibody test positive? If the later is true, then you already had chronic, not acute, HIV infection.

Also, you've got two CD4 counts that are virtually identical- absolute CD4 about 400 and CD4 percentage around 20%. These indicate to me that the time to initiating HIV treatment (irrespective of when you were infected) is not too far away.

If I were you and in a preventative state of mind, I'd start that dialogue with your doctor about when and what medications to start.

I hope this is helpful, BY


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