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HIV Drug ResistanceHIV Drug Resistance
           
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Jun 30, 2004

when i first found i was hiv + in dec 03 my vl-100,000,cd4-620,now june 04 vl-45,000,cd4-685 and my doctor has not placed me on any medicine,how did my vl drop without medicine and should i start medicine soon ? thanks james

Response from Dr. Sherer

The current HHS Guidelines suggest that treatment be considered when the CD4 cell count is below 350 or the viral load is above 55,000. You are thus in the 'grey zone' within which you and your doctor could reasonably choose to start treatment, or to wait and further monitor the trends in your CD4 cell count and viral load.

I would favor the latter approach, given the stability of your CD4 cell count for 1 1/2 years. Other information that would be of use includes the CD4 cell counts and viral load assays that you have had since the first value.

A significant change in viral load is 0.5 log or a 3-fold change. Starting from a viral load of 100,000, this means that a significant change would be to below 33,000 or above 300,000. So your recent change is not significant, i.e. it could be due only to the normal variation in the assay, and not reflective of any change in your viral load.

As always, I suggest that you pose these questions to your doctor.


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