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Author Topic: My First Blip  (Read 4091 times)

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Offline manhattanman

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  • Posts: 19
My First Blip
« on: June 29, 2006, 07:32:42 PM »
Anythoughts on this blip would be appreciated

started Sustiva & truvada 8/6/05  VL 70,000  CD4 298

9/20/05 VL 529  CD4 320
12?20/05 VL < 400 CD4 332...time to do mre sensitive VL test
3/20/06   VL -0-  CD4 361
6/20/06   VL 616 CD4 456

Have been 100% adherent, taking them between 11:15 and 11:30 PM, sometimes stretch to 11:45. Try and have finished eating 2 hours before, number of times went maybe hour to an hour and a half after eating but still took meds between 11:15 and 11:30.
Zero side effects, don't drink much at all 3 or 4 drinks a month
Have not completely quit smoking still 6 or 7 a day, that will change as of now.
Still work out, though not as much as I wold like, but excellent workout when at gym, plus cardio past-times (biking and lap swimming).


Friend told me not to worry, even that current thinking is coming around that blips may be a good sign.

Thoughts on blip ?

Offline J.R.E.

  • Member
  • Posts: 7,099
  • Joined Dec-2003 Living positive, since 1985.
Re: My First Blip
« Reply #1 on: June 29, 2006, 07:41:05 PM »
Hello Manhattan man,

I have been on meds since October of 2003. You can see at the bottom of my posts my track record ,since starting on meds. You can also see these occassional blips. I am still trying to understand it all.

I started a thread a little while back in referance to this, you may find it informative.

Click below :

http://forums.poz.com/index.php?topic=665.msg9535#msg9535


Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 12.5mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


 In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started my first  HAART regimen  on October 24th,03.

 As of 6/4/14,  t-cells are at 423, Viral load <40

 Current % is at 13% 

  
 62 years young.

Offline HIVworker

  • Member
  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #2 on: June 29, 2006, 07:52:40 PM »
If you are talking about the increase of ~600 virions a blip, you are mistaken. That's not really a blip.

R
« Last Edit: June 29, 2006, 08:04:57 PM by HIVworker »
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline gerry

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  • Posts: 522
  • Joined AM Feb 2003
Re: My First Blip
« Reply #3 on: June 29, 2006, 11:49:43 PM »
If you are talking about the increase of ~600 virions a blip, you are mistaken. That's not really a blip.

R

What would you call it?

Offline HIVworker

  • Member
  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #4 on: June 29, 2006, 11:55:56 PM »
You want me to define BLIP for you?
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline gerry

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  • Posts: 522
  • Joined AM Feb 2003
Re: My First Blip
« Reply #5 on: June 30, 2006, 12:03:01 AM »
Manhattanman:

Here's a good article regarding viral load blips:

Viral load blips

Here's another interesting article about viral load blips with NNRTI-containing regimens.

Viral load ‘blips’ on NNRTIs linked to low-level viral replication but not treatment failure

Technically, you cannot call the detectable viral load a blip yet until you know that it has gone back down to undetectable.  Is your doc planning to re-check your viral load sooner rather than later in order to find out where the viral load is headed?

Gerry
« Last Edit: June 30, 2006, 12:19:24 AM by gerry »

Offline gerry

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  • Joined AM Feb 2003
Re: My First Blip
« Reply #6 on: June 30, 2006, 12:03:44 AM »
You want me to define BLIP for you?

No, thanks.

Offline HIVworker

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  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #7 on: June 30, 2006, 12:07:48 AM »
I wasn't being facetious, although I admit my comment could be taken so. I was asking if you wanted me to define what I would call a blip.

R
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline gerry

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  • Posts: 522
  • Joined AM Feb 2003
Re: My First Blip
« Reply #8 on: June 30, 2006, 12:30:47 AM »
I wasn't being facetious...

Neither was I when I said no thanks...

Offline Jacques

  • Member
  • Posts: 171
Re: My First Blip
« Reply #9 on: June 30, 2006, 01:02:40 AM »
HIV worker,

Would you please define what is your definition of a blip.

Perhaps  other persons would be interested.

Jacques
Jacques
Living positively since 1987
latest lab :july 2010
Undetectable Cd4 1080
43% on Reyataz/Norvir/Truvada

Offline HIVworker

  • Member
  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #10 on: June 30, 2006, 01:09:52 AM »
One swallow doesn't make a summer. A Blip is where the viral load goes up and down again. The key is that to be called a Blip the pre-existing viral load has to remain somewhat constant. The viral load results here are not. They go from the 100s to nothing and back to the 100s. I would argue that this is a bounce along the line of undetectable due to vanishingly low viral loads. Experience has shown that even people who are undetectable have a viral load of between 2 and 20. If viremia is controlled this is the ideal number. However, as we know not everyone goes down to undetectable. This case it is almost so, but the levels have bounced around and not stayed undetectable enough to be called a real blip. If there were several measures of undetectable and then a 600 and back down to undetectable then this is a blip. If not then it's either settling down or is controlled somewhere between the undetectable and low 100s. Either way its still a good result and nothing to be worried about unless subsequent results show ever increasing levels of virus back to or approaching pre-drug levels. If the viral load keeps going up then it might be an idea to look at the virus.

R
« Last Edit: June 30, 2006, 01:13:40 AM by HIVworker »
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline Jacques

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  • Posts: 171
Re: My First Blip
« Reply #11 on: June 30, 2006, 01:22:32 AM »
Thanks Hw,

This confirms what is my understanding of a blip.

I had one in 2004 (jumping suddenly from 7years of undetectability to 72 viral copies. A controll test, done a month later, showed undetectable again). Never occurred since )

Jacques
Jacques
Living positively since 1987
latest lab :july 2010
Undetectable Cd4 1080
43% on Reyataz/Norvir/Truvada

Offline HIVworker

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  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #12 on: June 30, 2006, 01:24:41 AM »
That was a Blip.

R
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline Jacques

  • Member
  • Posts: 171
Re: My First Blip
« Reply #13 on: June 30, 2006, 01:29:13 AM »
.. forgot to say that my doctor said that the cause was probably a reservoir that suddenly emptied itself.  I guess that is plausible.

Jacques
Jacques
Living positively since 1987
latest lab :july 2010
Undetectable Cd4 1080
43% on Reyataz/Norvir/Truvada

Offline HIVworker

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  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #14 on: June 30, 2006, 01:33:04 AM »
It is, although I don't know which one. There are so many explanations it would be hard to pin down. The main thing is that it was undetectable again afterwards. It wasn't a big blip. More of a bli

R
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline Jacques

  • Member
  • Posts: 171
Re: My First Blip
« Reply #15 on: June 30, 2006, 01:46:20 AM »
Quote
More of a bli

 ;D

Your right,  but I did have been scared. I felt like "loosing my perfect score ".

cheers

Jacques
Jacques
Living positively since 1987
latest lab :july 2010
Undetectable Cd4 1080
43% on Reyataz/Norvir/Truvada

Offline jkinatl2

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  • Posts: 6,007
  • Doo. Dah. Dipp-ity.
Re: My First Blip
« Reply #16 on: June 30, 2006, 02:18:47 AM »
This is what concerns me a great deal. We are so obsessed with numbers that we fail to see the big picture. Suddenly a Blip, or a rise to detectable levels, becomes a Big Deal.

Isolating ANY area of blood work is a one-way ticket to crazy in the long run. The salient thing is, what does the entirity of the labwork say? What does the entire picture, over time, show us? And, of course... how do we feel?

I have discovered that the attempts to micromanage our labs from month to month is a recipe for unnecessary stress and even self-fulfilling treatment failure.

There IS no "perfect score" with HIV. We will ALL have blips, and burps, and oddities in our lab work. If for no other reason than the fact that the lab itself still struggles with identifying  viral particles down to the nanometer.

I had a complete blood workup done at my old doctor, with their own labs, before I went to my current doctor. He ordered a repeat of the bloodwork, using his lab. The results were stunningly different. Could have come from two different people. And tracking that blood work over time with the new doctor, it was obvious that the trends illuminated by this new lab were far more indicative of my overall health than the old one.

Thing is, once you go down to a certain level of detectability, the difference between testing facilities, time of day regarding the blood draw, external stressors, et al plays a siginifcant role.

Once I learned that a T cell count can vary up to a hundred points in a day, and that viral load can "blip" if there is too much smog in the air that day, I really stopped paying a lot of attention to any singular blood draw. I prefer to note trends over time. And one of the HUGE advantages we have with HIV management is time. We should cherish that gift.

"Many people, especially in the gay community, turn to oral sex as a safer alternative in the age of AIDS. And with HIV rates rising, people need to remember that oral sex is safer sex. It's a reasonable alternative."

-Kimberly Page-Shafer, PhD, MPH

Welcome Thread

Offline HIVworker

  • Member
  • Posts: 918
  • HIV researcher
Re: My First Blip
« Reply #17 on: June 30, 2006, 02:27:35 AM »
I would like to echo this statement. I have often wondered on the meaning of numbers, afterall people post their "New lab result!!" frequently. While paying attention to them is good and I cheer them with you, it is the trend and not the actual number that day that matters. You would no more predict the coming of summer by a warm day in early spring, nor say winter is coming because of a cold day in summer. It's the trend and not the weather that day, that is important.

R
NB. Any advice about HIV is given in addition to your own medical advice and not intended to replace it. You should never make clinical decisions based on what anyone says on the internet but rather check with your ID doctor first. Discussions from the internet are just that - Discussions. They may give you food for thought, but they should not direct you to do anything but fuel discussion.

Offline sweetasmeli

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  • Love what you are...
Re: My First Blip
« Reply #18 on: June 30, 2006, 03:15:05 AM »
You would no more predict the coming of summer by a warm day in early spring, nor say winter is coming because of a cold day in summer. It's the trend and not the weather that day, that is important.

I really like that analogy!

I have spent most of the past 3 and a half years since diagnosis watching my numbers like a hawk. It took upto my last blood results in March for it finally to sink in that little troughs and peaks in the numbers dont matter, that it is the overall CD4% that is more important, especially when the VL is low/undetectable. In a nutshell, my % has always been great. So last week when I came down with the shingles and was in the UK for my latest bloods, I took the clinic's advice and didnt bother having them done - they said (and I quote) "We can already tell you that they will be crap!" Fair enough!

Melia
(whose T cells may currently be depleted but not defeated!) ;D   
/\___/\       /\__/\
(=' . '=)    (=' . '=)
(,,,_ ,,,)/   (,,,_ ,,,)/ Cats rule!

The difference between cats and dogs is that dogs come when called, whereas cats take a message and get back to you.

Yeia kai hara (health and happiness) to everyone!

Offline Lwood

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  • Posts: 797
  • Here's Lookin At You....
Re: My First Blip
« Reply #19 on: June 30, 2006, 09:32:04 AM »
This is a really timely thread since Im going in for lab results Monday.  I should print this and hand it out to all of the other Nervous Nellies in the waiting room at the Clinic.
Some good points here  so, its not considered a Blip untill it goes back down, otherwise its an Increase ? that makes sense. I finally got around to Graphing my Labs which is a great way to see trends, even for someone with only 14 months worth of results to go by..In my case Spring is definitely on the way!! 

I guess I fell into the Numbers game for my first year after diagnosis, I suppose we all did. I guess its part of learning to live with it, Ill keep that in mind while Im chewing myself a manicure on Monday.
"Fortunately, I Keep My T Cells Numbered For Just Such An Emergency"
  -Either Foghorn Leghorn or Johnny Cash

Offline david25luvit

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  • Posts: 1,409
  • Member since March 2005
Re: My First Blip
« Reply #20 on: June 30, 2006, 03:28:23 PM »
Thanks for explaining a BLIP...  Just goes to show you learn something everyday.  Like Lwood (on Monday) I'm going in tomorrow and find out my lab results...  I'm not one to react to the "numbers' but I have noticed a disturbing trend in my labs that suggest my CD4 keeps going down and my VL keeps going up...  a trend that has been going on for the past four years...Wish Me Luck...and good luck to you Lwood :-*
« Last Edit: June 30, 2006, 03:31:09 PM by david25luvit »
In Memory of
Raymond David McRae III
Nov. 25, 1972- Oct. 15, 2004
I miss him terribly..........

Offline Christine

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  • Posts: 1,069
Re: My First Blip
« Reply #21 on: June 30, 2006, 05:40:43 PM »
The first time I went to the ASO, the caseworker told me to know what my numbers were, but not to let them guide how I felt. Your lab results are just part of your health. The doctor looks at your lab results over time, your physical health, your mental health, any OI's.

Your numbers can vary each day. If you have a cold, or are a little rundown, time of day, the day the labs were drawn...there are a lot of factors that can increase or decrease your counts. Maintaining a fairly stable cd4 % over many lab results, lack of OI's, along with how you are feeling are best indicators of your health.

I think your numbers are good. Don't let the numbers discourage you.
Christine
Poz since '93. Currently on Procrit, Azithromax, Pentamidine, Valcyte, Levothyroxine, Zoloft, Epzicom, Prezista, Viread, Norvir, and GS-9137 study drug. As needed: Trazodone, Atavan, Diflucan, Zofran, Hydrocodone, Octreotide

5/30/07 t-cells 9; vl 275,000

Offline MitchMiller

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  • Posts: 465
Re: My First Blip
« Reply #22 on: June 30, 2006, 08:37:54 PM »
After 18 months of undetectable, VL went to around 250, 3 months later to 780, 3 months later back to undetectable and has been there for over a year.
Some docs would have tried to switch my meds after the second "blip"... fortunately, mine didn't.

Offline randym431

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  • Posts: 1,115
Re: My First Blip
« Reply #23 on: July 01, 2006, 06:05:18 AM »
Somewhere I read, and maybe others can give more info on this, that a vl jump along with a good and increasing cd4 count can suggest that vl is not the same damaging vl. I guess I take it that this mutated vl jump does not damage the tcells. And the meds... or the persons natural immune system is capable of bringing this mutated vl in check. In other words, you have a mutation that does not kill or damage the tcells. And the mutation dies out, bringing you back to undetectable. Also, the whole time of this vl jump, your cd4 is un effected and still growing stronger. I'm probably not explaining this accurately, but this could explain vl jumps while the immune system appears to be un effected and still gaining in strength. Kinda like some mutations are bad, and some are harmless. But still counted in that vl and shows up in labs.

Offline Jacques

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  • Posts: 171
Re: My First Blip
« Reply #24 on: July 02, 2006, 01:46:26 AM »
Hey Randym, this sounds terrific. I simply love this possible explanation.  My immune system came back stronger after my blip .  Maybe some mutations could be benefic. ::)

Jacques
Jacques
Living positively since 1987
latest lab :july 2010
Undetectable Cd4 1080
43% on Reyataz/Norvir/Truvada

 


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