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Viral Load Progression
Sep 8, 2007

Recently I tested positive for HIV with a T-Cell count of 400 and viral load of 2,450 copies. My docotor says I do not need to be on meds right now. From this initial viral load, is there any way to determine how quickly this disease will progress and when will I need to be on medication? or will I ever need to be on medication?

Thanks Wayne

Response from Dr. Sherer

Yes, the way to tell whether or not you will need treatment is to continue to see your doctor and monitor your CD4 cell counts and viral loads. You can observe the trends in these test results with your doctor, and make the best determination as to whether or not, and when, to start ART, if at all.

There is no way from a single value to determine whether or not you will need ART, and exactly when. My advice is to assume that you will need to go on ART eventually, and that any time in the meantime off therapy is a gift to be valued.

My own advice to patients is that they start ART before their CD4 cell counts fall below 350 cells/ml, and the impetus to start ART is greater if their viral load exceeds 100,000. It is possible that treatment could be warranted for you as soon as your next blood test, and also possible that no treatment would be warranted for 3 years or more.

So....see your doctor every 2-3 months with monitoring of your CD4 cell count and viral load, and you will see trends in these values that will assist with the difficult decision of whether or not to start, and when.

I urge you to take this response to your doctor and discuss it with him or her.


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