POZ Community Forums
Main Forums => Living With HIV => Topic started by: songs06 on April 09, 2013, 08:17:51 am
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hi again,
i am on truvada kaletra for 9 months now. my previous lab results were cd4 650 and VL 20. my doc just called me and told me that i am still UD with my VL. but my cd4 went down a little bit and it is 460. i really don't mind having kind of low CD4 as long as i am UD. but from 650 to 460 is almost 200. i know it can vary +-100 CD4 but now i feel depressed. my doc told me it could just be unimportant viral infection. but still very confused and depressed because i was expecting to hear more than 500. do you think it is important? should i go do another cd count in a private clinic?
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hi Songs,
No need to worry!
CD4 counts can bounce around 100 points within ONE day.
Mine have usually stayed between 400-800 over many many many years. :)
With your VL being UD, there is nothing to worry about.
Many people here would love to see their CD4 counts reach your level.
m.
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Hi Songs ... sounds like your doing great so I really wouldn't sweat your recent labs . I lived for decades with cd4 counts in the 400 range .
You are correct that being undetectable is the key , so all is good .
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jeff and mitch, thank you very much.
i have been studying to a very very important exam for 3 months now. my immune system might be damaged due to stress. after reading your posts, i feel a lot safe. now i can focus on my study again. only one week to go now.
thank you again.
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What's your cd%? Has it changed since your last blood draw?
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i haven't seen the results myself. my ID doc is called me and told this.
but i also think cd% is more important at this point, because of it might be total lymphoid cell decline and not only cd4. so i will post it as soon as i see it.
also doc told me i have d vit deficiency, probably because of truvada. i also need to start use d vit and calcium. i feel like an osteoporotic old guy while i am still 26 :(
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i feel like an osteoporotic old guy while i am still 26 :(
Look at it this way - the supplements will stop you from being an "osteoporotic old guy" while you're still 26. :)
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Look at it this way - the supplements will stop you from being an "osteoporotic old guy" while you're still 26. :)
:) even it is a nice way of looking at the situation, i also know "truvada caused osteoporosis" is not only because of d vit deficiency but also because of somewhat 'unknown reasons'. d vit plus calcium tablets might not work at all. i hope it works and slows it down while new and better medicine comes to my country. i love truvada because it is powerfull and have no sensible (a.k.a. obvious) side effects on me. i don't want to change medicine while they are working good on virus. but it looks like this relationship won't last like decades :(
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Vitamin D deficiency might not be due to HIV but simply seasonal and locational. I know that since i live in NYC every winter my D plumets.
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Vitamin D deficiency might not be due to HIV but simply seasonal and locational. I know that since i live in NYC every winter my D plumets.
yeah there could be another reason. i've never heard of any kind of seasonal or locational deficiency, are you sure about that? while truvada being the most usual suspect, i also live sedentary for months now. and don't go out and do sunbath as well. but i eat mostly well, i don't think it is nutritional. my indoor life while studying plus truvada sounds more logical.
i have to go gym as soon as i finish my exam, it might also help. what do you guys think? does vit d helps most of the time?
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vitamin d comes from sunshine, so season and location directly correlate with the ammount of vitamin d in your system.
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vitamin d comes from sunshine, so season and location directly correlate with the ammount of vitamin d in your system.
oh ok, i see your point. that is true, i also spend all my time indoors. wonder if vit d tablets whether work on me or not.
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i've never heard of any kind of seasonal or locational deficiency, are you sure about that?
It's true. The further north you go in the Northern Hemisphere, vitamin D deficiencies in the general population go up. The same would apply in the Southern Hemisphere; vitamin D deficiency rises the further south you go.
We make most of our own vitamin D, and sunshine on bare skin is an essential part of the process. If you combine a lack of exposure to sunshine with a lack of nutritional sources of vitamin D, you can end up with a clear deficiency.
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Since we're on the topic of Vitamin D...
Mine is low at 12, again. Last year, I took the 50,000 iu once a week for 12 weeks. It didn't work. I have read you need sunlight to activate the supplement, or it likely won't work. But, it seems many docs are not sure. I've had a hard time figuring out which to take--D2 or D3. The prescription was D2. When I ask, they just say it does not matter.
I don't get enough sun. Depression issues have caused me to not want to be outside as much. And, low levels are associated with depression. I am now taking 2,000 iu a day now, and I've been getting out in the sun. It does seem to be having an impact. But, I just learned my B12 levels are low, which can also cause fatigue and depression issues.
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Perhaps I'm doing it incorrectly, but a multivitamin covers any deficiencies we may have. I never took them until I started having bone issues. I also added a calcium supplement since that's one of the things the multivitamin doesn't provide 100% of the RDA.
I have new labs new in 2 weeks so I'll be able to speak better on their benefit if I see a great increase.
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It's true. The further north you go in the Northern Hemisphere, vitamin D deficiencies in the general population go up. The same would apply in the Southern Hemisphere; vitamin D deficiency rises the further south you go.
The "cut off" in vitamin D deficiencies in the winter in terms of latitude are, for example, Atlanta (33.7 degrees latitude north) or Casablanca. There's not as much habitable land below -- Cape Town and Buenos Aires are all "above" that number, while Sydney is about the same as Atlanta. There's simply much more land in the northern hemisphere above a 33 latitude, not to mention higher populations.
btw, it only takes 10 minutes in the sun wearing shorts and a tank top to give you 10,000 units of vitamin D. Seriously, this should not be a difficult task even for a hermit. My vitamin D levels dropped something like one or two points below normal, so not a disaster, but it was noticeable because it was after last summer staying indoors 100% of the time recovering from my 2nd foot surgery. So now I'm making sure to go sit outside for brief periods, but I only need to do that on days when I'm not out running errands.
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well, after this week i will spend all my time outdoors :) i also start vit d so i hope those things will work. but articles say only d vit might not help, i also need calcium to reduce my PTH levels. well still, i always thought osteopenia stuff is something i have to deal in distant future. but now i started to fear supplements are not gonna work and i end up osteoporosis before 30.
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btw, it only takes 10 minutes in the sun wearing shorts and a tank top to give you 10,000 units of vitamin D.
True for many, but not for all. The darker your skin is naturally (ie without a tan), the more exposure to sun you need to make enough vitamin D. Very fair people don't need much exposure at all - and it makes sense when you consider that fair skinned people have mainly northern geographical origins in their ancestry.
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by the way,
i got my full results. it says:
cd4: 460 cd8: 1130 cd4/cd8: 0.4 (yeah not exactly but close)
3 months ago it was:
cd4: 650 cd8: 1200 cd4/cd8: 0.5
and VL is now 54 (last time it was 20)
well i am new with being undetectable. so i am not sure 20 and 50 means any difference? i guess not still being less than 100, that might count as undetectable as well.
but cd4/cd8 ratio fall 0.5 to 0.4; it looks suspicious, and might be significant? does anyone know anything about this?
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None of those changes are very significant. You still haven't listed what your cd4 percentage is/was.
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sorry, i thought you meant cd4/cd8 ratio, because people mostly use it in HIV forums.
total lymphocyte count is 2088 with 460 cd4. i guess it is like %22. (i also have total 5000 leukocytes.)
but i don't have the previous total lymphocyte number, only have cd4/cd8 counts so i'll post it next monday.
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now i have got another cbc and lymphocyte subtyping. and cd4 still declining :(
total leuko 5600 lympho 1960 CD4 431 cd8 980 cd4/cd8 0.4
total lymphocyte count lowered 120 and cd4 lowered 30 as well. that means my cd8 also decline. should i worry? my doc out of country and not sure about the results. i did a new VL test waiting for the result.
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You do realize that your numbers will fluctuate and go up and down, up and down, for the rest of your life. If your going to worry every time you have a slight drop your going to be in for a long rough ride.
Again, you failed to list your cd4 percentage which has most likely not changed this entire time.
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because i don't know what do you mean by cd4 percentage? cd4/lymphocyte or cd4/total white blood cells or cd4/cd8. in my result paper, there is only cd4/cd8 odd, there is no cd4 percentage. so i wrote that. my old result from 4 months ago, i only have cd4 number and cd4/cd8 ratio and it is now harder for me to learn because my doc is out of country for a while. i'll try to ask my doc via mail or i could just drop this chase entirely and do another test 1 month later. it is most likely just a lymphoid suppression due to overly psychological stress.
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because i don't know what do you mean by cd4 percentage? cd4/lymphocyte or cd4/total white blood cells or cd4/cd8. in my result paper, there is only cd4/cd8 odd, there is no cd4 percentage. so i wrote that. my old result from 4 months ago, i only have cd4 number and cd4/cd8 ratio and it is now harder for me to learn because my doc is out of country for a while. i'll try to ask my doc via mail or i could just drop this chase entirely and do another test 1 month later. it is most likely just a lymphoid suppression due to overly psychological stress.
Songs, I hope this helps.
What is the CD4 Percentage?
If you look at your lab report, you will also see something called your CD4+ percentage (%). This is an important number for you and your doctor to know. In healthy adults, the number of CD4 cells make up between 32% and 68% of the total number of lymphocytes?a large group of white blood cells that include CD4 cells, CD8 cells (see below), and B-cells. In fact, the lab uses the CD4 percentage to determine the number of CD4 cells in a sample of blood.
The CD4 percentage is sometimes a more reliable measurement than the CD4 count because it tends to vary less between measurements. For example, one person's CD4 count may vary between 200 and 300 over a several month period while their CD4 percentage remains constant at, say, 21%. Provided that the CD4 percentage stays at 21% or higher, the immune system still appears to be functioning properly, regardless of what the CD4 count is. At the same time, a CD4 percentage at or below 13%?regardless of what the actual CD4 count is?usually means that the immune system is damaged and that it is time to begin prophylactic treatment (drugs to prevent diseases) for opportunistic infections like PCP.