cd4 750, 45,000 viral load one yr later

Question

Hi, I tested positive in October 2005, I actaully tested hiv negative with the conventional hiv test however I was so sick that I thought the worse and my doctor tested me for the virus itself; and it came back positive. Essentially I was converting and had a sphillis co-infection. At that time my viral load was over 500,000 and my cd4 count was 280. In January 2006 my viral load was 46,000 and my cd4 count was 780. One year later, October 2006 my viral load was 45,000 and my cd4 count was 750. I was a bit upset because it seemed like nothing changed with my viral load, it was as if my numbers didn't move. My doctor told me not to worry about numbers, however, he is not living with this. He did say that the VL is not as important as my cd4 count which technically did not move, 780 to 750. In your opinion, do you think it's a good sign that my cd4 was 780, VL 46K and then a year later it was 750/45K. Is that honestly a good sign? Thanks.

Answer

There is essentially no difference between those two CD4 counts, and both are in the normal range. The CD4 count can vary for a variety of reasons including time of day, stress, ongoing infections, among other reasons. Your values are within assay variability and are remarkably constant for a one year interval. Ditto for the viral load. That viral load is probably what your setpoint viral load is now after acute infection. It is unlikely to go down much further on its own without HIV treatment, which don't need at this point.