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Need Some Answers
Dec 15, 2007

Sorry to make this long, but I recently tested positive and had: a genotype, a CD4, and a viral load test done. This was almost a month ago and I've heard no results from my physician. I did obtain the results though from my wonderful health department. They said my CD4 was 750 and my viral load was 59,000 copies. She didn't have the genotype though. Why is the health department receiving my lab work before I do? So, I looked these results up in my lab manual from nursing school and it says that treatment is recommended. I really want to know if this is a new infection, and to me, what these lab results mean is that yes, I have a high viral load, but it hasn't started effecting my CD4 level yet, therefore yeilding a recent infection. The whole experience was classic initial infection signs though. I mean I had a cold for a week and a UTI. Then I took some prescribed antibiotics lost the cold, but was left with a fever, lethargy, and lymphadenopathy. To me all of that screams primary infection. My physician keeps saying remember a couple years ago when you were sick, and the answer is a resounding NO. I had a negative test a year ago. So, could you please clear that up for me. I'm also a traveling nurse and was wondering where I should take my next assignment or if I should even keep taking assignments. Basically what are the best cities to live in for treatment?

Response from Dr. Young

Thanks for your post.

I wouldn't (or couldn't) conclude that yours is (or isn't) a recent infection. You do have a CD4 count in the normal range and an average viral load.

Your lab manual is wrong. Having an extremely high viral load with a negative antibody test is the way that recent infection is diagnosed. Since many persons with acute infection actually have little or no symptoms, you lack of symptoms in the past doesn't necessarily mean that you couldn't have been infected at that time. The most compelling part of the lab data is the negative test 1 year ago- implying that your conversion happened in the past year.

As to where to live, most major US cities have excellent HIV care centers. One unspoken barometer of the standard is to look to the American Academy of HIV Medicine's provider list or to contact the local AIDS service organizations (ASOfinder.com).

I hope this helps to clarify things. Write us back anytime if we can be of assistance. BY



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