CD4 and Viral Load right up - No meds - Can it be right?

Question

I am one of those people whose circumstances make it difficult to get medical help in an easy and straightford way. What you do is especially valuable for people like me. Thank you.

I am a European living and working in Taiwan. Taiwan is one of those countries where a person can be deported just for testing positive. But my life and my work are here so I want to stay as long as I can. I can access some medical support and get CD4 and VL tests through using a pseudonym and with the help of a sympathetic doctor. Some drug treatment might be possible but I have to be careful because even though I pay my medical insurance premiums like everybody else if I claim for HIV drugs I will be deported. (Any protest that this is against human rights is met with the retort that the USA discriminates against "foreign" PLWHA, why shouldn't we too? But that's another issue.)

My last negative antibody test was in April 2001 in London. I believe that I contracted the virus in February 2002 because I had a severe viral illness for a few weeks in March. I had some blood tests (in the UK) towards the end of that period which showed this i.e. abnormal lymphocytes, etc but no antibody test was done.

In August 2002 I got an anonymous HIV antibody test in Taiwan which was positive. I had three visits to a clinic in London following this and my results were as follows:

20 August CD4 446 (percentage unknown) Viral Load 75000 03 September CD4 284 (percentage unknown) Viral Load 81865 17 September CD4 266 (CD4 = 15 percent) Viral load 91000

The doctor doubted the accuracy of the first CD4 number because she said that the "percentage is not right".

I returned to Taiwan and got a CD4 and Viral Load test. These are the results:

19 October CD4 1117 (47 percent) CD8 772 (33 percent) CD4/CD8 ratio=1.45 Viral Load 371000

I am told that all the viral load tests, both in London and Taiwan, used the Chiron DNA method.

I feel much better than I did when having my bloods done in London, if it's relevant.

Of course, I'm happy with the CD4 and slightly (but less) concerned with the VL. What should I be feeling and wht do those results mean? The doctor seemed not to know what could be happening, she muttered something about a very long primary infection period. But she didn't think it could be a lab error. But apart from a lab error what could it be? Have you ever seen anything like this before? How should I interpret things: can I trust my labs and what prognosis do they indicate. I want to start on medication a little bit before 200 CD4s if I can and don't have any symptoms before then.

Thanks for reading, both you, doctor, and everyone else! Sorry for all the detail but wanted to make sure I didn't miss anything out because this is all so strange.

Answer

The 3 lab sets from London show remarkable consistency, both in terms of CD4 count and viral load. I am concerned about the CD4 count from Taiwan. It must be repeated. If in fact your CD4 count and ratio is that high, then you have some time in terms of making a decision to start treatment. If your CD4 numbers are more like those from London, with a 300,000 viral load, I would recommend treatment sooner rather than later.