Disease progression and time of infection.

[EmilyRay]

Hi everyone,

I'm not sure if this belongs here or not. I have a question about determining a time of infection. My girlfriend was diagnosed hiv+ in April of 2008 with a viral load >10,000,000, CD4 count was 152. How long would she have been infected to have those numbers? The reason it is important is because this was just 2 years after being discharged from the Navy. If the disease progressed at a normal rate is it possible she was infected while in the Navy making for a possible disability claim if a nexus can be found. She didn't have a discharge physical before leaving the service.

EmilyRay

[Miss Philicia]

There is absolutely no way to answer this question.

[Ann]

Emily, I have moved your thread into the Someone I Care About forum. As you are not hiv positive yourself, it is the more appropriate place for your thoughts and concerns.

You should only post in the Someone forum. I've left the other post you made in the Living forum, but please do not post in that forum again.

One posting exception would be the Treatments forum, but only for asking treatment questions in a polite and respectful manner, never for answering the questions of others.

The only other exception is the Off Topic forum, which is a place for things that have nothing to do with hiv.

Thank you for your cooperation.



As Miss P said, there's really no way to answer your question definitively. It could be (and is very likely) that she tested positive during primary infection, meaning very soon after she was actually infected.

It's common for a person in the primary (aka acute) phase to have an extremely high viral load, very often coupled with low CD4s. People in the US military are usually routinely tested for hiv, and this is why I said it's very likely she tested positive during primary infection.

If she somehow slipped through the military's hiv testing net and had already been positive for some time, it's actually near impossible to know how long she'd been infected. Some people progress very quickly, and some people can take ten to twenty years to progress to having numbers like her initial numbers.

At this point I suppose it would be helpful to point out that the VL is normally extremely high during primary infection, and it will normally go down on it's own over the next 6-18 months. The body's immune system can keep the virus in check for a while (people's mileage will differ), and a typical untreated VL can remain in the 20-50,000ish range for some time. Please remember I'm speaking in generalities.

Ann

[EmilyRay]

Maybe additional information would be helpful. Within a year of diagnosis she was having opportunistic infections like Thrush and Shingles with Hiv wasting and had been given just months to live if she didn't start HAART. She was a healthy adult before diagnosis often swimming and running for miles. I don't think there is any doubt that she is a quick progressor, but one year from diagnosis to AIDS in a healthy adult according to a CDC information is rare. I know it can progress faster if acquired by blood transfusion and in children with infants being the fastest progressions, but she is neither. I know there can't ever be 100% certainty and she doesn't need that to prove her claim. A probability is enough.

EmilyRay

[Jeff G]

I would think it would be a uphill battle trying to convince a doctor to investigate or put their name on a medical report stating with any certainty when the infection took place . I could be wrong but my 30 years as a patient I have learned a few things about doctors and disability and it tells me that trying to get disability pay takes rock solid medical findings and that will be extremely hard to generate in this situation .   

[Ann]

I don't think there is any doubt that she is a quick progressor, but one year from diagnosis to AIDS in a healthy adult according to a CDC information is rare.

It's not that rare.

US military personnel are usually routinely tested for hiv. She should be able to find out the date of her last test - it will surely come out in any disability claim. The date of her last negative test result could/should shed some light.

Stress of diagnosis can cause shingles (anyone, of any age, who has had chickenpox can get shingles when under stress, it's not limited to hiv positive individuals) and stress can also cause weight loss. Antibiotic use can cause thrush, again, in anyone. What I'm trying to tell you is that none of the "opportunistic infections" you list are hiv-specific. If you'd reported something like PCP, that would be another matter.

From your other posts, it sounds as though she has a similar problem to what I have - hiv-related gut issues. These can start right away, even in a person with otherwise good numbers. This very possibly is a cause behind her weight loss and isn't necessarily aids (as opposed to hiv) related because as I said, it can happen even with good numbers. Hiv-related gut issues aren't easy, but can be controlled, at least to the extent that one can get on with their life. I have.

I hope your girlfriend finds solutions to her problems, but please be aware that getting approved for disability may very likely be an uphill struggle and very stressful. Good luck!

[JR Gabbard]

Jeff asked me to pop by here and help out.
Ann and Miss Philicia are correct; there's no way (that I know of) to pinpoint one event as the cause of seroconversion.  Neither is the "counting backwards" method helpful here.
Fortunately (and unfortunately) for EmilyRay's girlfriend, that's not what she needs to prove.  She needs to prove she was infected while on active duty, either with a positive test, which I assume is not available, or by showing that she showed up to sick call with unexplained infections.  That's a big red flag for HIV infection, though.  A test would have been ordered.  See where this is going?
Get her service treatment records, and take them to your county Vet Services offices to see if they can help.