I was infected with HIV on may 2005 (age 28). The cd4 count after acute infection was 460. Last year CD4 count was 650 and now dropped to 278, viral load increased from 14 000 to 100 000. I felt perfectly well. I havenāt had even a cold during that time. What may cause such fast progression of disease? My doctor is surprised that it goes so fast. She predicted that I will need meds in 10 years.

There is a wide range of progression from initial HIV infection to AIDS (either clinical or CD4 count < 200). The fastest I have seen AIDS develop after infection is a few months while we follow a number of long term non-progressors or elite controllers who remain in good shape blood test wise (CD4 count >> 350) even after 10 years. The average without treatment was about 10 years in the pre-treatment era. What explains the wide range is progression rate is still a focus of research. Genetics (ie HLA and CCR5 receptor levels), degree of immune activation, thymus activity, HIV virulence (ie CCR5 vs X4 virus) and other factors may contribute to the rate of progression. There is a trend towards starting antiretroviral therapy earlier overall (sooner after infection) in order to optimize overall health outcoms (beyond just AIDS) and decrease HIV transmission. KH