How fast does an untreated HIV+ person lose T-Cells? How long would you guess an untreated person with a VL of 400,000 and T-Cell count of 290 have been infected? What is the normal T-Cell baseline for the average person? Is it normal(or highly likely) for a young, otherwisee healthy person to have had a baseline higher than the norm? Can an infected person (male) still father a biological child? If so, how?

Well - let's review the basic issue. When the virus grows it does damage to the number of T4 cells. And the more virus, the more the damage. So the higher the viral load, the more damage is being done. In a person who is untreated with a viral load of 400,000 - we expect a range of 50-100 cells or more per year that can be lost. The numbers lost however vary - by a lot - it is hard if not impossible to accurately guess/predict when HIV started in any person since there are unmeasurable variables like the health of the immune system other than just the count of these cells.

A person who is HIV negative often has a T4 cells count anywhere from 500-1500. The average is over 800, but again does vary. A person who is positive can also have a variable count - it can vary by time of day, and from day to day - it is not surprising to see a range of bouncing around as much as 60 cells in the range you mention. So even the 290 you mention will bounce around.

So as you can see it is very hard to know when in a person HIV first arrived - in the numbers you mention - it could be anywhere from 2 years if the person had 500 cells at the beginning, to 12 years if they were 1500. And while it may be that a healthy young person had a higher than normal value when negative, we just can't predict... And while the viral load is often a set number we have learned more recently it does often rise over time, so yet another confusing piece of the puzzle in trying to go backwards. What all this means is we can't tell from these numbers when HIV showed up.

As for your last question on fathering a child - there are groups and people working on this. Fortunately the HIV is not inside the sperm cells - but may be in the seminal fluid or the cells that can be in this fluid. So - some centers work on separating the sperm (which are the cells that actually lead to fertilizing the egg) from the seminal fluid. And we have learned that usually when the blood values of HIV are below detection, the seminal fluid levels go down as well. Unfortunately there are exceptions to this - so it cannot be assumed. But it is a way to improve the odds.

Hope that clarifies. CC