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Newly hiv+

Dec 15, 2007

Hi Dr. Frascino, I recently learned I am hiv+. First thing I did was find a hiv specialist who I liked -- can't tell people how important it is to have a health care provider you like. My viral load is 198 and CD4 453. Given the new guidelines to start treatment at 350, I am wondering what the correlation between the two is. Will my CD4 stay at that level if my viral load stays low or will I lose 50 -75 per year as I have read is the average, no matter what my viral load is. Thank you for all that you do, lkc ny ny

Response from Dr. Frascino


I cannot give you a specific answer to your question, because HIV disease can be quite variable from person to person, due to a side variety of both host and viral factors, including viral strain, host immune integrity, concurrent coinfections, etc. The 50-75 CD4 cell loss per year in the untreated HIVers is an average and primarily based on historical epidemiological studies done prior to the availability of potent anti-HIV therapies. In most cases there is an inverse correlation between HIV plasma viral load and CD4 count: If the viral load is high, CD4 counts decline and if the viral load can be optimally suppressed, the CD4 count rises as the immune system becomes at least partially restored. What will happen in your case? We can't say for certain. That's why a close relationship with an HIV specialist is so crucial, as you mention in your post. Your HIV specialist will monitor both your HIV viral load and CD4 counts periodically and watch for trends. You are correct: The newest version of the ever changing treatment guidelines recommends treatment begin when the CD4 count hits the 350 range. For those interested in the new guidelines, check out Dr. Gallant's summary of this information on the pod cast (or in the transcript) easily accessed on The Body's homepage.

Also, since you are recently diagnosed, you might also find the information in the "Just Diagnosed" and "HIV Monitoring Tests" chapters very helpful. These can be accessed under the "Quick Links" heading also on The Body's homepage.

Good luck. Be well. I'm here if you need me. Let's get through this together, OK?

Dr. Bob

Deep, deep depression continues
HIV Testing with Immune Deficiency?

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