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Strange labs results...

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giorgio76:
Hello guys...

I tested poz two months ago...  My first CD4 count was not good at all. 190 cd4 and 22000vl. I couldn't believe that i was so bad. My doctor told me that i should take medicine immediately. Also told me that probably i had infected many years ago (7-8 years). The strange thing is that from 1999 to 2005 i have 4 negative tests and i was completely healthy. We repeat the tests (after a week) and it was a bit better... 237cd4 and 13000vl.

Does this difference make sense? Is there any possibility to be at the first steps of hiv? On the other hand the virus load shows that the virus is not very efficient and probably i have it many years... But the negative results???

Anyway... i started Meds last week Kaletra + truvada... No side effects at all... and this is good :-)

LT:
CD4 counts are pretty variable. A change of 47 could easily be the difference between feeling a lot of stress, or having a sniffle one week, and feeling a bit better the next.

Remember it's trends that are more important than actual numbers.  Two results are not enough to determine an upturned or downward trend.  They are close enough that they may be in the realm of statistical error

Neither viral load is high enough to be of great concern.

The most common first round of HIV tests tend to have more false positives than false negatives.  A positive result there is usually confirmed with a second, different test. I'd be more inclined to believe the four negative results than suspecting that they were all wrong.  You doctor was just making a guess - purely a guess - based on your low CD4.

While the "not very efficient" thesis is possible, it's not all that common.  Though it certainly could be an indication that your body is good a fighting off the virus.

Another possibility is that with that low a CD4 count, there's not a lot of raw material from which to manufacture new copies of the virus.

Don't obsess on the numbers too much.  They can drive you crazy.  Wait for more results to see where the trends are headed.

Side effects can take some time to kick in, while to drug builds to critical mass in the body.  For example allergic reaction often take two weeks to manifest themselves.

Hopefully your "side effect free" experience will continue

Matty the Damned:
Giorgio,

Welcome to the Forums!

First up, HIV antibody (ELISA) tests do occasionally throw up false positive results. That's why positiive ELISA tests are confirmed by a follow up Western Blot test. In some rare cases people return negative antibody tests when they are in fact positive, but such people have other serious health problems. These sorts of things include taking immuno-suppressants following transplants, chemotherapy and having a history of long term serious injecting drug use.

Clearly you don't fall into these categories.

Nevertheless you have a detectable viral load and your CD4 count is indicative of HIV disease. As LT notes, absolute CD4 counts such as the ones you've shared with us here tend to fluctuate wildly. A much more reliable indicator of HIV disease progression is the CD4 percentage. Do you know what your percentage is?

Also the combination you're on is a powerful one and it's great to hear that you're not experiencing any side effects. Keep us informed.

Regards,

MtD

Ann:
Hi Giorgio, and welcome to the forums.

It sounds to me like you are dealing with a recent infection. It is quite common for the CD4 to drop and the VL to be through the roof in primary infection. For your doctor to make such pronouncements based on one set of results is remiss. Did you tell him you tested negative as recently as 2005?

As you've already started meds, you will have no way of knowing if your CD4s would have recovered on their own - which they probably would have. The viral load will also typically drop to a much lower level once the body has had a chance to get things under control on its own.

I really don't understand why some doctors are so quick to jump on the meds, especially in a patient who is not experienceing an OI with those kinds of numbers. One set of lab results doesn't really tell them anything much at all, again, especially when the patient isn't symptomatic - and especially when the patient isn't symptomatic and has had a fairly recent negative test result - someone such as yourself.

Hang in there!

Ann

fondeveau:

--- Quote from: Ann on May 18, 2007, 08:47:44 AM ---
I really don't understand why some doctors are so quick to jump on the meds, especially in a patient who is not experienceing an OI with those kinds of numbers. One set of lab results doesn't really tell them anything much at all, again, especially when the patient isn't symptomatic - and especially when the patient isn't symptomatic and has had a fairly recent negative test result - someone such as yourself.


--- End quote ---

Its possible that it is sound medical practice.  There has been recent research or at least news that starting treatment earlier may provide long term benefits.  Of course, its always up for debate and each individual's course will be different.

I can say that I had a similar pattern of negative results and a CD4 of 285 and VL of 30k when I first say my ID specialist in October 2006.  They indicated that they would have believed me to be infected for five years, but for consistent negatives.  The alternative thesis was that I had a very strong immune system.  But, without prior baseline measurements, who knows.  My own thoughts were that the infection was recent and that perhaps I was seroconverting at my first appointment as I was suffering from very flu-like systems. 

At any rate, I've been on Atripla since mid-October 2006 and my CD4s are now 734 and undetectable.  Do I wish I had avoided treatment?  Nope, the more "normal" every test is, the better I feel.  For me, treatment is reassuring beyond waiting for some OI or other possibly irreparable damage.

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