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What does it mean?
Jan 29, 2009

I have been diagnosed with HIV since 1996. I probably contracted it before then but that is a starting point. My CD4 has been between 400 to 550 and my viral load has been consistantly in the 3300-3700 range,. Since it has been 12 years and still on no meds, what does this mean? Is my body keeping things in check and is it possible to keep this up indefinitely? No one has been able to give me some kind of answer and I was hoping you could help.

Response from Dr. McGowan

I am glad you ahve been doing so well. There is definitely a balance between the immune system and the particular viral strain that is established in each person living with HIV. The height of the viral load is usually associated with how fast the CD4 count will decline. Your viral load is relatively low for a person not on treatment. So a slower progression would be expected. The average time from infection to developing illness from HIV is around 9 to 10 years...that means that half of people (like you) will not get sick after 10 years of being infected. The factors that cause the viral load to be lower in one person than another (called the viral set point) are not all known but some of them include: the strength of your immune response against HIV (through your CD8 cells), the number and type of co-receptors on your CD4 cells that the virus uses to attach to the CD4 cell, the presence of other infections that would stimulate the immune system and may cause more rapid progression, and which receptors your virus uses to enter the CD4 cells. We can't be sure how long things will stay stable, but you should continue to be monitored closely and also continue to protect yourself against getting "re-infected" with HIV since a different strain may cause a more rapid progression.

Good luck,

Joe


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