Question

Do these lab results mean my HIV is progressing?

20 May 2008. Related: All topics, CD4 and viral load.

Hi, I was diagnosed last August 2007. Since then my CD4 count was on the rise and my viral load on the decline:
August 2007 – CD4 354 VL 7,500
November 2007 – CD4 410 VL 6,180
January 2008 – CD4 540 VL only 48 (which was considered undetectable).
I was very happy about this results.

However todays results came back as CD4 438 and VL 11,470 and its really concerned me why the VL went up.

My CD4% has been kind of steady 29.3% back in August 2007 to 27% on the last result.

I am afraid that i might be getting sick or will need to start medication soon

Answer

Answer: Simon Collins

Hi

Both CD4 counts and viral load results can fluctuate on a daily basis without it meaning that your immune system or amount of virus has changed in any significant way.

At higher levels (above 350) CD4 counts can easily change by 50-100 without it meaning anything. Only if this happens at each visit and there is a clear trend, would the results be interpreted as showing a real change.

With viral load results there can be even broader ranges because of the limitations of the tests. A viral load result can be three-fold higher or lower and still considered the same result.

Your CD4 counts don’t show any clear trend to be dropping. The average fall off treatment is only around 50 cells a year.

Your viral load results would all be interpreted by your doctor as the same result – apart from the undetectable result, which was probably a lab error.

None of your results suggest that there is any urgency to starting treatment, if you are otherwise healthy, and this is not what you want to do.