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Need advise
Nov 1, 2012

Hello dr, I am a 30 year old my reports are as follows. First report. CD4 . 750 cd4% 27.65. Viral load 105 but states that lowest detection point of it is 400

Second test January : CD4. 1090. Cd4% 26.50.

Could you please state how is my condition is it that I am many years far from medicines. One general question is that can a person without HIV have cd4 % below normal too.

Response from Dr. McGowan

HI and thanks for your questions.

Right now your CD4 count is relatively high (although the CD4% is lowish) and the viral load is low off medication. That is a good combination, in that it may take several years for the CD4 counts to drop significantly. Most experts recommend ant-viral treatment regardless of the CD4 count, but if you were not ready for treatment you could wait till CD4 count reached 500. Again this may be a few years based on these values. It would be important to have the numbers checked every 4-6 months to be sure they remain stable. Sometimes the viral load can increase and cause the CD4 to drop more quickly. This can happen as the virus changes it's ability to infect CD4 cells (called a tropism shift- which happens to the vrus in over half of people with HIV over several years) or reinfection with another strain of HIV (which is why it is important to continue to practice safe sex).

People without HIV can have "abnormal" CD4 counts and CD4%. The "Normal" range is defined as an average across people. There are always people who are outside the normal range, on the high and low side. Without them life would be boring!

Best, Joe



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