Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

High VL


Background: Back in November I had 700-something CD4s and a VL of 40K. Jan-Mar I was on a completely insane project in rural Florida, logged nearly 1100 billable hours in 12 weeks. Obviously me and my job were not very kind to my body. Then had a ton of dental work.  In April I had 530 CD4s and 400K+ VL.  OUCH.  Last week I had 450 CD4s and 212K VL. 
With these last results my doctor said that he'd like to get another bloodtest in September and then talk about meds. He was happy that the VL dropped by 50%, obviously the lower CD4s are not good.  But, am I not just delaying the inevitable? Has anyone every seen their viral load drop from 200K back into the "reasonable" range without meds? I worry that I've royally screwed myself.  I know that the CDC gives that 200-350 window for starting meds, but why wait until then?  It seems that people with lower CD4s when they start meds take longer to get them back up (a totally unscientific observation of mine). Maybe I should just get on them now.  (I did a year of meds when I was diagnosed, hated the side affects, but was very adherent to the dosing schedule).  Any thoughts, personal stories or suggestions are welcome.  Maybe I'm just worrying too much.



Unfortunately, the high viral load, which has persisted for a couple of months now, will be a predictor of how fast your CD4 would decline.  You might want to use this time to decide on which meds you'd want to go back on considering your previous med experience (you don't have to be on the same ones) and resistance test results (can't remember if you had one).  You don't have to rush to starting it immediately since your CD4s are still good and waiting between now and September would probably not make a whole lot of difference clinically, but if you are able to get yourself ready sooner, then you could ask your doc to advance the appointment.  Good luck.


Steve, I am in a very similar situation. My VL has reached 100.000 copies and my cd4 are 539-26%. The Dr. wnats to see me in August. Ill have my bloodwork done the 2nd and my appointment with the Dr. the 14TH. He said if my viral load was still as high and my Cd4 droped below 450 I would start treatment.
Anyway, whatever the counts are, I am going to start on meds. Why postpone the unavoidable?

Agree with Gerry. Many docs would recommend starting treatment at that VL, even with CD4s in the 400s.

Btw, have you ever thought that the Donne quote was a bit excessive, rhetorically over-the-top? "Each man's death diminishes me, for I am involved in mankind. So send not to find for whom the bell tolls: it tolls for thee." (I'm probably misquoting a little.) Beautiful and noble, but... psychologically accurate? 


Thanks for the responses.  I feel that I should probably start meds.  I was cruising along for a year and a half with good labs, it is hard to accept that those days are gone.  And hard to accept that my last project for work was probably just too much for me to physically handle.  Damn HIV.  But being on the meds will probably be better in so many ways. Maybe I'll stop worrying so much.

Jay:  you think the Donne quote is excessive? No one has ever said that. Maybe it is.  The quote has always been very meaningful to me since I first read it in college. I added to my bio here about two years ago because I felt it quite appropriate for this forum.  At the time I remember reading some threads where one member really helped out another, and in turn a third person was aided by simply reading the thread. I was in excellent health at the time, but found that my heart was quite heavy for those who were having a much harder time with the virus and O.I.s.  When you read the entire meditation, Donne describes humankind as an island, when the sea washes away some of the sand, the entire island is changed. At the time I felt that when one of us were hurting or struggling, the whole group was feeling that pain. And when I'm feeling down or ill, I read through the success stories for comfort.  I'm not really the philosophical type, usually I'm quoting Dorthy Parker or some campy 80s movie rather than a 17th century English poet.



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