Recent bloodwork questions

[HIV? poz about being neg]

Hi guys question regarding my latest bloodwork I have been on Atripla since April 2010 and undetectable since December 2010. The question I have is I was looking at my test results and the CD8 Abs is 1340 and should be between 160 - 1020
And my CD4/CD8 Ratio is 0.56 and should be between 0.69 - 5.00
Should I be concerned about the high CD8 and the low CD4/CD8 ratio?

My current CD4 is 750 at 29% and Undetectable.

[elf]

My current CD4 is 750 at 29% and Undetectable.

This is the most important part.

CD4:CD8 ratio may return to normal values,
or may not, but it's not something you should stress yourself over too much,
it's just a marker of persistent immuno-activity to now non-replicating virus.
Clinically speaking, it can be compared to mild autoimmunity.

(The same happens in parasitic infection called leishmaniosis,
even when patients are cured [cleard from it] their immune cells
are still hyperactive as if the parasite were still present, and it's
a form of mild autoimmunity).

My numbers are similar to yours,
and I have ''reversed'' CD4:CD8 ratio,
but I guess I'll have to live with it,
It hasn't gone down in 6 years of me being positive and taking meds.

My CD4:CD8 is lower even when my CD4 are high (around 1300,
my normal range is wide: 600-1400), this would mean my ratio could only get in the normal range
if my CD4 were >2200 .

You can find interesting articles on the ratio here:
http://scholar.google.com/citations?user=wuqpqrAAAAAJ&hl=en

The CD4/CD8 ratio in HIV-infected subjects is independently associated with T-cell activation despite long-term viral suppression

The CD4/CD8 ratio as a marker T-cell activation, senescence and activation/exhaustion in treated HIV-infected children and young adults

The CD4: CD8 ratio is associated with markers of age‐associated disease in virally suppressed HIV‐infected patients with immunological recovery

[elf]

Predictors of CD4:CD8 Ratio Normalization and Its Effect on Health Outcomes in the Era of Combination Antiretroviral Therapy

 

We have examined the potential role of the CD4:CD8 ratio as a marker of immune status, in particular as a measure of immune recovery on cART. We found that CD4:CD8 ratio normalization occurs rarely; even after several years of cART. Failure to normalize CD4:CD8 ratio was not associated with an increased risk for ADIs/death provided HIV was well controlled. Future studies should determine if this marker of persistent immune dysfunction is relevant to non-AIDS outcomes such as risk for cardiovascular disease and cancer.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0077665

[eric48]

CD4:CD8 normalization is not that rare...

reading a chart that I have on top of my head and not on this PC, ca. 10-15 % will have a normalized ratio at year 4 of treatment and 30-40% at year 7, when it seems to plateau.

So CD4:CD8 normalization , defined as CD4:CD8 > 1, should be around 30% in most clinics

Studies are undecided whether or not there is an attached clinical importance. (here again, I am not in front of my own PC...): some say yes, some no, so ... if there is a role is is most likely minimal and secondary

I go with the vizualisation that some activation remains, which others call inflammation. This activated state is not bad, but, of course, one would like it better if it where not there.

I have never worried to much about it

If ratio goes >1 it may flicker there for a while

Once it goes > 1.2, it usually stays > 1.2 (but may vary)

I have mapped my own ratio progression and you will find it at:
www.tinyurl.com/HIVPharmaCure

go way down, I think on the lower section of page 3

Eric

[elf]

30% is still infrequent (and most of these ''lucky'' ones are those who started taking therapy at higher numbers, that is when their CD4/CD8 ratio was 0.5 or higher).

I started taking meds at CD4 of 353 (CD4/CD8 ratio of  0.19, extremely low)

My CD4/CD8 ratio is stuck at 0.8,
it's not because my CD4 number is low (my CD4 is 1000+/-250)
but because my CD8 number is too high.

I remember Miss P. once wrote here, that in order to get stubborn CD4/CD8 ratio up,
one should take Fuzeon, for at least a year.

If Fuzeon does indeed help, that means, failure to achieve normal CD4/CD8 values, while undetected on therapy,
is due to  subclinical replication of virus.

Given that my doctors think my numbers are excellent (which I consider utter nonsense), I will get my lab results done only once a year (a cost saving measure). So, I won't be able to track my CD4/CD8 dynamics any more.

My only hope is fluvoxamine-boosted melatonin, which lowers inflammation/IL-6 and slows down immunosenescence.