Important note: Information in this article was accurate in 2004. The state of the art may have changed since the publication date. Dear Doc,
I have a patient that has been symptomatic for the last 2 months
yet has tested negative now for over 3 months since his last
exposure by PCR-RNA and ELISA/WB.
Although, there seems to be one problem with is CD4 ( I only did these tests at his request). They have been at 800 in the 1st month, 600 in the second month and now at 1200 in the 3rd month. Even the percentages have been dropping and increasing.
While browsing the archives I can across one of the replies that stated that this trend in CD4 is usually associated with people who are recently infected.
Please advise me what to do as this is the only troubling point at the moment.
Although HIV acute seroconversion illness may produce flu-like symptoms, the duration of these is short. It would be unusual for a patient to have symptoms for two months. The conditions your patient has might be related to some other condition.
Currently, his CD4 count is 1200. He has not experienced terribly low counts that have remained low, and I don't think the pattern of changes is particularly suggestive of HIV infection, especially if he has had PCR-RNA that is negative.
Perhaps there is something in this clinical history that has you
concerned. The details with which you have supplied me would, at
this point, suggest follow up, looking for other possible causes
of his symptoms.
I hope I have been of some help.
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