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vl fluctuation
May 5, 2008

Ive been hiv+ since 1998,in Aug 2007 my cd4 was 351,and my vl was 127000;in Mar 2008 my cd4 was 252,and vl was 86000. Why would the vl go down without any treatment and is now a good time to start arvs, I havent had any cllinical symptoms as yet.Thanks

Response from Dr. McGowan

The viral load test can fluctuate a bit off treatment so it is not unusual to see the pattern observed with your test results. In fact, the test can vary up to 3-fold. That means your viral load of 127,000 in Aug 2007 could fall anywhere between 42,000 (3 times lower) to 381,000 (3 times higher) and still be considered in the same general range. Sudden changes in viral load should be confirmed by repeat and regular testing.

Starting HIV treatment is a decision you have to make with the help of your provider. The current treatment guidelines suggest that individuals with CD4 counts below 350 even in the absence of symptoms would benefit from antiretroviral treatment.

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