Question

I’m newly diagnosed and starting treatment, what should I expect?

11 October 2012. Related: All topics, CD4 and viral load, Newly diagnosed, Starting treatment.

Hi there

I was diagnosed last week with HIV; it’s been a pretty tough few days since then.

I’m 27, in good health, not unwell except getting colds and maybe ulcers in my mouth.

My initial test results came back today as CD4 count 297 and viral load 760,000.

The viral load seems quite high and the CD4 count a bit low. I’ll be meeting with doctors next week once a resistance test has been done to see what treatment I can have.

I’m quite worried about the viral count though, are there any common reasons as to why it may be this high?

Also, upon starting treatment, I assume this will go down quickly and that hopefully my CD4 will go up to that of a normal person over a few years to 500?

I’m quite scared at the moment as this is all new to me and has been a huge learning curve and a kick up the bum to sort my lifestyle out (eat healthy, exercise more etc).

I would be grateful for any advise you can give. Thanks!

Answer

Answer: Rebecca McDowall

Hello,

I’m very sorry to hear about your recent diagnosis. Finding out you are positive is never easy, and it’s normal to feel frightened and overwhelmed. Have you been able to tell anybody else about your diagnosis, and do you have any support?

Your CD4 count and viral load are both indications for starting treatment. In the UK it’s recommended that people start treatment if their CD4 count is under 350, or their viral load is over 100,000.

Your viral load is high, but this is not unusual. About 15% of people start treatment with viral loads over 500,000. This may mean that you have been infected for some time, but it is also possible that this is a recent infection- please see this graph for information about how viral loads change during infection.

Treatment brings your viral load down very fast. ARVs starts working in the body within the first few days of starting treatment.

UK and US guidelines recommend that your viral load should be undetectable within 3-6 months. However, many people achieve this within the first month. A few people take longer, especially if their viral load is very high when they start treatment.

Once your viral load is under control your CD4 count will start to increase. Your CD4 count is still relatively high so you are starting from a good point. Everybody responds differently but this graph shows the average CD4 increases after starting treatment.

I hope everything goes well with starting treatment. Please let us know if you have any questions or concerns!