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HIV+, non-progressive?
Oct 15, 2001

I was recently diagnosed and my cd4 count was 1222 and my VRL was 52, after major abdominal surgery my CD4 count is 1067 and my VRL undetectable. My physician has mentioned that I may be a non-progresser. How long does it take to confirm that? I've had the virus for 2 years and the western blot showed 7 bands. My other question is: Do t-cell counts vary in uninfected individuals? Thank you so much for your help. I'm new to all this and this web site is a great resource.

Response from Dr. Young

We have difficulty in predicting exactly who will be a long-term nonprogressor. However, viral load after acute infection is a pretty good predictor of the rate of CD4 cell decline. Hence with a viral load around 50, we can be fairly sure that your rate of progression will be very, very slow (remember that the median viral load is somewhere around 50,000 copies).

We have also recently learned from two studies published in last month's (Sept 2001) New England Journal of Medicine that the presence of a virus coinfection called GBV-C (or hepatitis G) seems to confirm improved survival for HIV infected individuals, even at low CD4 count levels. The mechanism for this is not clear, and this should not be construed as a rationale for getting infected with GBV-C. It might be that those persons whose immune system permits GBV-C replication might be less susceptible to immunologic damage from HIV, for example.

Lastly, absolute CD4 counts vary widely in one individual through the course of a single day. The absolute variation is greatest with high CD4 counts, and can be as much as 20% of the total. We like to look at CD4 percentages- since they vary less; careful assessements of CD4 cell levels requires looking at trends.

I hope that you find this helpful, good luck. BY



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