CD4, Testosterone & VL

Question

Infected in Sept 2003. Age 65. Male.

Married to negative partner (same age) for past 9 months (lots of protected sex). She is very positive on "us" beating this disease.

CD4 Helper stayed at 20,000 to 45,000 from late 2003 until January 2006(28,266). In April it jumped to 58,330 and in July it aws 74,302

CD'4 % was steadily falling from 45%-50% range to 40% last Xmas and last 6 months in the 27% range.

CD8 Suppressor was in the 300 to 400 range for 3 years and then shot up to 760, 561, 804 & 874 since Nov 2005.

Obviously the CD4/CD8 ratio has steadily declined from 2.25 to .65 lately.

My weight is unchanged during the 4 years.

My Testosterone, serum has consistently been at or near 800 to 1,100. I use 5 grams of Androgel daily. In the past 2 blood tests, my testosterone went from 1.047 (Jan 2006) to 559 in April, 2006 and in July, 2003 to 150.

I regularly exercise, eat too many carbs & sweets, drink very little beer and do not smoke. For the past 5 months, my energy level on the golf course was waned and I am very tired after 18 holes (play 4 times p/w and carry my golf bag).

My doctor said that we need to consider med's as I've had 2 successive (3 month intervals)measurements of my v.l. over 45,000 copies.

He does not understand why my CD 4 has not fallen.

I wonder if the sharp decline in my testosterone levels can cause the v.l. to rise while not affecting the CD 4?

Answer

Your increase in viral load is really not that significant and within assay variability. you don't actually state what your CD4 count is, although your description of the CD4 percent decline appears to be real. If your Cd4 count is still over 400 you can probably afford to wait to see how the trend looks on the next set of numbers or two. There is not a good correlation between testosterone levels and viral load. If your CD4 percent is declining and correlates with continued increasing viral loads, then perhaps it's time for HIV treatment.