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Rapid CD4 Drop -- What happened?
Jan 27, 2007

Dr. Bob,

I was Dx as HIV+ in September 2006 after seroconverting in August 2006. At that time, I had a viral load of over 500k. My next test was a month later, with a CD4 count of 411 and a load of 83,000. Now, in early January, my load dropped minimally (67,000), but my CD4 droped to 262 with a CD4 ratio of 21.9%. My doctor was very concerned and said that meds may be required soon. In retrospect, I had partied very hard the weekend before the test, and the day after the test I noticed that a recurrent eye infection had resurfaced. Could the combination of those (stress, partying, bacterial infection) at the same time have caused my CD4 to plummet that quickly? Or is there some other factor I should be aware?

Response from Dr. Frascino

Hello,

Decisions should never be made on the results of a single blood test result. If, indeed, you are recently infected (not just recently diagnosed), your body's immune system could still be kicking in and you may not have firmly established your "set point." This is the equilibrium between all viral factors (viral strain, etc.) and host immune factors (immune response, etc.). In addition, intercurrent infections could indeed transiently decrease CD4 counts. I would suggest you repeat your CD4 and plasma viral load under better circumstances (read: decreased stress, no partying and no concurrent infections), perhaps in a month's time, to get a clearer picture of what's going on. If ultimately, after extenuating circumstance have been eliminated as the possible cause, your CD4 counts remain consistently in the 250-350 range, I would suggest you begin HAART.

You can read much more about HIV tests, HIV meds and staring therapy under the "Quick Links" section on The Body's homepage.

Good luck.

Dr. Bob



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