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Huge change in cd4, treatment still warranted?
Feb 9, 2008

I was diagnosed HIV+ in October 2007. My first labs, Nov 2007, showed cd4 of 480 / 26% and viral load of 3990. My immunologist wanted me to start treatment early and, after lots of research and one posting here, I was inclined to agree with him. My second labs, Jan 2008, show cd4 of 920 / 21% , viral load of 2270, wild type virus with no resistant mutations. My doctor is still leaning toward treaatment. With Atripla now instead of a Truvada/boosted PI regimen, although I have not started any treatment yet.

He initially thought I may have been infected for 3-5 years, but thinks now that this might be a recent infection. I'm neg for all other STDs and neg HEP. I've started vaccination series for HEP A & B. I have not seen any posts here where cd4 counts vary so much or so quickly. If this were you, would you wait for another set of labs or start the treatment?


Response from Dr. Wohl

I would wait. Your CD4 cell count is high and your viral load is low. The change in your counts from November to January are not necessarily an indication of recent infection as your CD4% actually dropped and the viral load was essentially the same. The absolute cell count can vary quite a bit, especially at high counts.

There is no indication for HIV treatment now unless you have major symptoms due to the virus. Any attempt to treat you now should be considered outside the box. Were you to have a significant and sustained decline in your CD4 (by % and absolute) then we could talk meds.


Resistance problem
Bleed during intercourse

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