Aug 22, 2012
hi young, my wife has undergone a CD4/CD8 and PCR RNAntest again after 5 months of initial detection test. at initial test her CD4 count was 504 and now it has reduced to 443. Her viral load at initial test was 274 copies/ml and now she has 4467 copies/ml. within this much given time does this level get low in such a way or is it due to some other reason. i have checked with some doctors they say that " initialy the test was done with some lab. and now the test was done with some other lab due to which there could be a big variation in the results" and preffered me to get her tested again in the same lab in which earlier test was done. please let me know if this thing is correct and what should be the next step towards treatment for it. in india they say they dont start until the CD4 level goes below 350. what are the chances for me to get infected at this virus load by intercouse.
Response from Dr. Young
Hi and thanks for posting.
There are a number of reasons why viral loads can fluctuate- I agree that the change from 270 to 4500 seems greater than expected, unless there was something activating your wife's immune system during the second test (like an infection or recent vaccination). Laboratory variability could explain part of the differences, and could normal biological variability (usually in the range of 5-fold).
Either way, both numbers reflect a lower than average viral load (that's a good thing).
As for her CD4 count, you've not listed any numbers, so I can't speak to her current health or whether she'll meet Indian criteria for starting on HIV medications. Here in the US, the most current guidelines suggest treatment for most individuals, and prevention of HIV transmission to sexual partners provides further justification.
As for the risk of HIV transmission to you, it's probably pretty low- on the basis of her lower than average viral load and that insertive sexual partners are generally at lower risk. There is a nice chart that outlines risk of HIV transmission by type of sexual exposure.
I hope that's helpful, BY
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