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Meds or no meds

Mar 14, 2010

I was exposed to HIV in early November 2009. I was tested a month later and found out I was positive. Additional blood tests showed a viral load of 140 and t-cell count of 223. My doctor was somewhat concerned about the t-cell count but was pleased with the viral load. He said my t-cell count took a hit but my immune system was doing a great job of holding the virus at bay for now. As a result, he recommended no meds at this time and to come back in 3 months for another blood test. Although I trust my doctor I see so much conflicting advice online that I am not sure if I should get a second opinion or just relax and follow his advice. So, I guess in fact, I am asking you for a second opinion. Thanks

Response from Dr. McGowan

Thanks for the question.

I am not convinced that the timeline is accurate. I would recommend much closer follow-up and most likely treatment if repeat testing confirms these numbers. Usually if a person is infected within the month they will have very very high viral load and may have a low dip in their CD4 count. This can correct over the next several weeks to a higher CD4 and drop in the viral load. Your finding of a low CD4 and low VL is not consistant with that. Therefore they should be repeated. If the same pattern is found then treatment should be started since a rebound in CD4 would not be likely with such a low viral load to begin with. It would be more consistent with a long-standing infection that may not have been recognized before. Had you been tested in the past? Either way 3 months is too long to wait.

Best, Joe

Resistance to NNRTI and Sensitivity
New Norvir

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