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Examining the Past
May 14, 1998

Hello.

I've posted to this forum before. Before I ask any questions I just wanted to say that the service you are providing is invaluable. I know you must put in a lot of extra time to field these questions. The effort is appreciated.

I don't how long I've had HIV. I became aware of the infection three years ago from an ELISA test when I was going to donate blood. Since that time I've had CD4's and viral load checked every quarter. I maintain all of the tests on my computer and plot the numbers looking for trends. My VL has varied from 500 to 4000 over the last three years, last test was 700. My CD4's vary from 200 - 350. Last one was 200 (one of the lowest, but it has been there before, the last several tests were 200, 266 306, 240, 196). My CD4 percentage hovers around 15%. Bottom line, there has been very little, if any, change in 3 years. I take no antivirals, I've decided to just watch my bloodwork and start treatment only if there is a trend change. What drives me crazy is wondering how long I've had HIV and how I got it. I had a blood transfusion in 1982. If that is how I was infected then I guess I'm in some type of slow progressor category. I've pored over my test numbers, attempting to plot changes and then project backwards to determine an infection date. My numbers have been stable enough that this approach hasn't worked. I believe that knowing the past is a good way to plan for the future. My question is this, given three years worth of blood tests (taken every quarter) is there any type of mathematical or statistical technique that I could use to figure out my infection date? Is attempting this a waste of time? If I really have had the virus for sixteen years I wonder about the CD4 decline slope. Since it has been pretty steady for the last three years I wonder if the decline was greater in the early years, or if my pre-HIV CD4's weren't that high to begin with? Any advice appreciated.

Response from Dr. Murphy

Dear Questioner,

You will never figure out your infection date unless you remember a time when you had high risk activity (like sex or the transfusion) and several weeks later, you got a severe flu-like illness. In any case, it doesn't matter. Your CD4 cells are rather low, and you should consider starting treatment at this point. The treatments are a lot better these days. CD4 cells in the 200 range are not good. You need to act.

RM



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