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CD and Viral load

Jun 25, 2011

Dear Dr Bob, Am not sure the question belongs in this category, but could you please explain my trivia. In Feb i had a viral load of 10,000 and CD count of 579. I took my blood work two weeks ago and now i got my results The viral load was 7,700 and the CD was at 600. I got the results thro the phone as am on holiday. Am not on meds yet. I expected that without meds the CD goes down and the viral load goes up. Mine seem to be the opposite. Thank you so much.

Response from Dr. Frascino


Untreated HIV is a very slowly progressive illness. Over time CD4 counts fall and the viral load will eventually rise.

There are several potential explanations for your lab results.

1. Lab technical or clerical error (doubtful).

2. If you were only recently infected, your immune response could still be adjusting toward your viral set point. Early in HIV disease the viral load usually skyrockets and CD4 counts plummet. As the body's immune response kicks in the viral load falls and the CD4 count can increase. Eventually a temporary equilibrium is reached called the viral set point. Subsequently, left untreated, the virus slowly destroys the immune system, CD4 cell count decreases, viral load goes up and an increased risk for opportunistic illnesses arises.

3. You could have a wimpy strain of virus and/or be a non-progressor.

When evaluating CD4 cell counts and viral loads, you need to look for trends over a longer period of time to know what's really happening.

Dr. Bob

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