Viral Load and CD4 Count

[creativesurfer]

Hello Good People
I'm wondering has this happened to any of you, and what's it about??

The background to me first:
infected in 2001, december-ish
diagnosed in december 2004

So this year life has been sweet, I'm super well and regularly greeted with, "Wow Pete you are looking so good!" from those who do and don't know my status.  There's been a two week snotty nose, but I've got through some major stress and hard work with no sickness, and I'm still not on meds.

So this year my tests have shown a pattern of fairly constant CD4 and constantly falling viral load (13 500 in January with CD4 at 370
then in September: CD4: 338 Viral Load: 7014 21,4%
and now in December: CD4:273 Viral Load 2616 16,95%
SO MY QUESTION: what's with the CD4 count falling even as the viral load continues to drop??
I would so appreciate any insight you may have.
regards
Px
Creativesurfer

[John2038]

Again, I would look on the ratio CD4/VL.

That's what IMHO is the most important.
I'm not an expert at all.

But it make sense to say that the relationship between CD4 and VL might be close to predator prey model in ecology:

Example:
http://www.stensland.net/java/erin.html  (http://forums.poz.com/index.php?topic=17613.msg223323#msg223323)

Personally, I'm maintaining a graph CD4/VL VS. time. If the curve decline, so is doing my immune. If the curve goes up, so does my immune system.

There is a limit to not go under whatever the ratio is: at least the DHHS recommentation (CD4<350 or VL>100k or OI, etc.)

[sacinsc]

My CD4 count kept crashing too. But my VL was higher. There really was no explanation form my crash other than the amount of stress I was under. Was healthy as ever. My ID Doc doesn't thing the % is important so unless I ask for it he doesn't tell me. Once I went below 300 my doc immediately put me on meds and my CD4 went up.

Don't, know what else to tell ya cause I am no expert either. What does your ID doc say about?

Matt

[esquimau]

I'll respectfully disagree with John on the value of a CD4/VL ratio.  Not seen that documented anywhere as a indication of anything.  To me they are to different measures of your health.

As for your CD4 decline, just from cursory looking at the two points of time you reference, I would say don't worry too much yet or read into it.  CD4 count is prone to variation.  Your CD4 count will be lowest in the morning and higest in the evening.  Any acute infection, cold, fly, cold sore, etc can cause your CD4 to dip down.

The change in viral load I don't think is that significant either.  Viral loads you usually look at in logarithmic scale, so this variability may not be anything.

[Matty the Damned]

John has invented this CD4/VL thing all on his own. As far as I understand there is no basis in clinical practice for it.

MtD

[vokz]

John has invented this CD4/VL thing all on his own. As far as I understand there is no basis in clinical practice for it.

QFT

[newt]

CD4 counts vary by +/- 50 on accuracy of the test, and vary more according to time of day, other infections, whether you slept well etc.

Viral load tests are accurate within a range of 3 times more/less than the figure given (ie result could mean your viral load is as high as 3 times the number or as low as 1/3rd the number).

Therefore your figs suggest a stable pattern.

Another low/lower CD4 and you could fairly conclude that your CD4 count is declining (towards the point where guidelines recommend treatment). Before treatment and especially at the low level you indicate, your viral load is unimportant.

CD4/VL ratio -- this is not an established metric of any kind.

Hope this helps.

- matt

[creativesurfer]

guys just wanted to say thank you for the input.
I've been missioning to find a way to do a personal reply but just not managing the systems
respect
Peter

[allopathicholistic]

guys just wanted to say thank you for the input.
I've been missioning to find a way to do a personal reply but just not managing the systems
respect
Peter

you'll have to post once more and the system will allow you (minimum 3 posts)