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recent HIV+ brother
Oct 9, 1996

My brother just tested positive - the doctor estimated he has had the virus for four years. I don't understand the process that his body has gone throughin the last four years and what to expect in the future. In other words,please explain the stage that he is in (still HIV, not AIDS) and what wecan expect to see.

Response from Dr. Cohen

Keep in mind that your brother's doctor's estimate is just that, an estimate. Because people progress at such different rates, and start with very different CD4 cell counts, it's really not possible to accurately estimate the amount of time that someone has had HIV infection based on laboratory tests alone.

The stage of disease is not based on the amount of time you've been infected. It's based on the CD4 cell count and the symptoms or complications of HIV infection that are present. You didn't tell me that information, so I can't comment on his stage of disease. The current stages of HIV infection can be divided up like this:

Acute retroviral syndrome: the illness that some people get within a few weeks of infection.

Asymptomatic HIV infection: the stage that it sounds like your brother is in, when there are no symptoms of HIV infection

Symptomatic HIV infection: formerly known as "AIDS Related Complex" or "ARC." Symptoms include fevers, night sweats, weight loss, oral thrush, diarrhea, to name a few.

AIDS: Defined by either a specific AIDS indicator condition (opportunistic infection or malignancy), OR a CD4 count less than 200.

Some would further break this down and talk about "Advanced AIDS" or "Advanced HIV Infection," which would usually be characterized by a CD4 count less than 50.

I think, though, that you're asking for a prediction of what will happen to your brother and when, and that I can't give you. Let's just say that we can now do more than ever before to delay or halt the progression of HIV disease to more advanced stages.



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