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Questions, and dudes from Buenos Aires
Oct 8, 2005

Dear Keith

First, sorry for my english, Im from Argentina and my english is terrorific!!!! I wiil try to do this in the corrct form.

First my status:

HIV + in March 05. Whitout drougs for the moment.

1.- March 520cd4 (29%) 600.000 cv

2.-May 609cd4 (31%) 238.000 cv

3.-july 590cd4 ( 30%) No carga Test.

4.- Agost 700cd4(35%) 180.000

5.-Octo 660cd4 (30%) 123.000.

Questions:

1.- Respect to my CD4, is this my Set Point?

2.- In my last lab, my CD4 go down to 35% to 30%.Is this alarm? significative?

3.- My CV is Go down ( whit out drugs) month to month, Why? is likely go to indetectable staus whithout drougs?

4.- How many time do you consider that i can state whit out drugs? one year more?

Dear Marck, thans for your help and for try to understand my englis!!!!!

Un caluroso abrazo desde Buenos AIres

Response from Dr. Henry

The HIV viral set point would be defined as the level achieved after 6 months or so of infection. You may have been identified relatively soon after infection which is a time when the viral load is often very high. If often will drift down over a 6 month period though rarely goes to undetectable. The CD4 count is more important for the decision when to treat in the absence of any HIV-related symptoms. I generally don't recommend starting HIV therapy until the CD4 count is < 350-400 on several occasions. Your CD4 % is still good so I generally would not recommend starting therapy now if you have no symptoms from the standpoint of your own health. If you are sexually active without condoms then there is a public health benefit to your partners if you go on effective treatment so the decision to go on treatment involves lots of different factors.

Your viral load is considered relatively high but I am increasingly convinced that the viral load is not as important as the CD4 count for the when to treat decision. Good luck. KH



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