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my CD4 versus viral load
Feb 9, 2008

dear doctor, i hope you are doing fine. i am worried and my doctors here in venezuela seem not to be able to answer my question. i was disgnosed with hiv on jan 31st 2007 my viral load has increased, 87000 copies, however my CD4 count is 864, it has not only kept good, instead of going down is going up, what ahould i do? should i be happy? should i be worried since viral load is going up like crazy? please let me know when you answer, hugs

Response from Dr. Frascino

Hi,

Your situation is not all that unusual. CD4 counts can remain in the normal range, bouncing up or down, for quite some time while HIV plasma viral load rises in HIV-infected folks not on antiretroviral medications. Ultimately with sustained high HIV viral loads the CD4 count will begin to decline, dropping on average 50-75 cells per year. You should monitor not only the absolute CD4 count, but also the CD4 percentage, which is a bit more accurate when following trends. Should you be happy? Sure! Your immune system is holding up well despite the HIV infection. Perhaps you've acquired one of the less virulent (more wimpy) strains. All you need to do is follow your counts, both immunologic (CD4 and CD4%) and virologic (viral load) every three months. And, of course, also remember to follow safer sex guidelines to avoid transmitting virus to others.

Be well.

Dr. Bob



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