High viral loads, so starting meds.... have a question

[InChicagoNow]

I started meds 3 days ago (Isentress and Truvada) with no apparent sides effects.  Things are going well so far.  However, in the last few weeks that I've had a higher viral load, I'm noticing body changes that I'm questioning if they are typical for my situation.  In general, I'm noticing my body is slower at healing itself.  I'm bruising easily... even a small zit that normally would go right away turns into a huge gross thing.  I've been a red wine drinker almost every night for the past several months.  I've never had any alcohol withdrawal symptoms before if I go without it.  However, the other day in the grocery store (after almost 2 days without alcohol), I had a seizure!!!  I found out on the net that it is a typical symptom of extreme alcohol withdrawal.  I was wheeling my cart down the aisle one minute... the next, I was in an ambulance.  I don't remember it at all, but all my muscles are really sore and I bit a pretty good gash into the side of my tongue.  A lymph node below my jaw swelled up and is almost back to normal now.  But it seems like its healing so slowly.  Are my body's slowed and intense responses to injuries, etc...  a reflection of my high viral load???  I've been poz for 3 yrs and have been very healthy until now.    I guess I just want to set my mind at ease that it's the virus in my system causing these changes... and that I don't have something else really wrong with me.

[Inchlingblue]

When talking about matters related to HIV it's a good idea to also consider CD4 count (and to a certain extent, CD4%), which you don't mention.

[InChicagoNow]

My viral load skyrocketed... my t-cells didn't go up by much.  My doctor said if we did not start meds, my t-cells would eventually follow.  He said it would be better to start meds before that happens.

[Inchlingblue]

But do you know what your Tcells count is? I don't think you mentioned it in your post, unless I missed it.

[InChicagoNow]

My t-cells are 446 and haven't waivered much at all.  Viral load went from hovering around 14k for 3yrs and now up almost to 100k.

[Inchlingblue]

The reason it's important to know is that CD4 count is the main thing to look at when assessing immune health, along with viral load of course.

Based on your numbers it's hard to be able to tease out what is due to HIV infection and what is not. The slower healing can possibly due to your viral load increase. As far as the seizure this is more difficult to assess, but didn't the doctors who examined you have any ideas? I've done a huge amount of research on HIV and have never come across what you describe with your seizure experience. The kinds of seizures that come from alcohol withdrawal happen to people who drink alot of alcohol. How much red wine do you drink daily?

The important thing is that Isentress/Truvada is a great combo (I'm on it and very happy with it) so your viral load will very likely be decreasing to undetectable as long as you are adherent. Since it is twice a day, are you doing anything to make sure you remember to take them? I use my cell phone alarm, set for twice a day every day, 9AM and 9PM.

There is some small leeway when it comes to adherence (as far as missing a dose) but that leeway applies more when on is already undetectable. When there is still a viral load, it's even more important to be 100% adherent.

[InChicagoNow]

I drink anywhere b/w 1-4 glasses of wine in the evening.  I'm hoping that my body just isn't in the healthy state that it usually is, and therefore, reacting differently than it normally would.  Once I came to in the ambulance I declined to go to the emergency room (the ambulance was just sitting outside the grocery store).   Thanks for the info. though.  I'm looking forward to getting back to my old self!

Scott

[Miss Philicia]

While I'm obviously not a doctor, I agree with Inchling that this seizure incident doesn't sound like it has anything to do with HIV infection, nor does it sound like it is alcohol related as your consumption while on the high side isn't outlandish.  Could be, but also is as likely not to be.  However I do find it odd that you're here on a message board expressing concern, while at the same time you declined to discuss that at the ER and are seeming to decline to follow up with your HIV specialist or GP.  What's up with that?  If it is some other underlying medical issue that is not connected with HIV infection you still need to get it sorted out.  Having a seizure in a grocery store to the point where an ambulance is called isn't something that you just don't even make a phone call about the next day.  This is simple common sense frankly.

[InChicagoNow]

While expressing my concern, I'm certainly not in a state of panic about it.  The alcohol was the first thing that came to mind when I had the seizure.  I actually will bring it up to my HIV doctor when I see him in a couple of weeks.  An emergency room is the last place I wanted to be after that incident... and I knew enough to keep my thoughts about the cause to myself.  Today was the first day I really started wondering if it was all related.  I've never been in this situation, so my first instinct was to try a few of my poz friends on the phone to see what they thought.  Since it was the middle of a work day, I kept getting people's voicemail.  Then, I thought, I'd ask here.

[Miss Philicia]

I'd still encourage you to place a call to your doctor.  It will put your mind at ease and, possibly, get your appointment moved up.  Best of luck and keep us posted.

[confidentIwillbeOK]

An emergency room is the last place I wanted to be after that incident... and I knew enough to keep my thoughts about the cause to myself. 

...for me it would have been the first place I would want to be!  Lacking that (...and I understand the trepidation) I would make an immediate appointment with my PCP or ID doctor to make sure there wasn't a time sensitive issue lurking.  The combination of all the things you mentioned (slow healing, sore muscles, swollen lymph nodes, passing out) may be worth checking out before you appt in 2 weeks.

Hope you are feeling better soon.

S.

[newt]

It is important to note that HIV is a massive burden on the body, especially with a high viral load, and it can only do so many things at a time; treatment allows a more normal response, eg symptoms to a cold etc.

- matt