Title : HIV and viral load
 
Clinical Problem : A 9 years old HIV infected boy was referred for further management. He had been tested for HIV as his brother was HIV infected. The patient was currently asymptomatic and CD4 count was 1078 {30.5 percent}. He was advised regular follow up. At 11 years, his CD4 count was 473 cells, cumm. At 13½ years of age, his CD4 count was 1297 cells, cumm and at 15½ years of age, his CD4 count was 804 cells, cumm but HIV viral load was 5, 83,300 copies, ml. He was still asymptomatic though his weight was 31.3 kg and height was 144 cm and Tanners Stage 2 of puberty.
 
Question : Should this child be started on antiretroviral therapy {ART}_?
 
Expert Opinion : This child though has a good CD4 count has growth failure in form of short stature and also has a high viral load. Thus, he should be started on ART as that would improve the growth.
He was started on consisting of Zidovudine {AZT}, Lamivudine {3TC} and Nevirapine {NVP}. His height increased to 150.2 cm in next 6 months. Thus, in patients with HIV and normal CD4 count, the growth would be in an important parameter to decide regarding antiretroviral therapy. In case of growth failure and viral load More than 1,00,000 copies, ml one may consider antiretroviral therapy.

E-published: August 2011 Vol 8 Issue 8 Art No. 55
 
Funding : None
 
Conflict of Interest : None
 
DOI No. :
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