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Viral Loads and AIDS
Jul 23, 2010

Hello Dr. Bob!

Just recently I initiated the first blood test ever in my existence. I was soon diagnosed with HIV and two weeks later diagnosed with AIDS. Evidently, I should have been more proactive about getting tested because my T-cell count was 150 and viral load 44,000. Based on these numbers and the progression to AIDS, my doctor says that it is apparent that I've been infected for some time. After searching the Internet, I cannot discern how serious my condition is. Is my viral load considered as high or moderate? Also, I'm starting HIV meds within the next 3-5 weeks and DESPERATELY want to know what to expect. Will the meds decrease my viral load thus increasing CD4+ counts??

Response from Dr. Frascino

Hello,

Sorry to hear about your recent AIDS diagnosis. It appears you have much to learn about HIV and its treatment. You've come to the right place! I'd suggest you spend some time reviewing the wealth of information here. Begin with the chapter called "Just Diagnosed" (under the heading "The Basics" on The Body's homepage). From there you can branch out to other topics, including HIV-monitoring tests (viral loads, CD4 counts, etc.), medications (including side effects and toxicities, etc.).

Regarding your current situation, I agree you've most likely been HIV infected for quite some time, perhaps 7 to 10 years. Your immune system has been significantly damaged, leaving you with increased susceptibility to opportunistic infections, such as PCP (pneumocystis carinii pneumonia). You should be started on PCP prophylaxis (Bactrim DS) in addition to your combination antiretroviral therapy (cART). I agree you should start your cART immediately, primarily due to your severely depressed CD4 count. Your HIV plasma viral load is moderately elevated.

If your cART is successful, it will drive your HIV plasma viral load down (hopefully to undetectable levels) and allow for some degree of immune reconstitution (increase in CD4 count).

Good luck.

Dr. Bob



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