Quantcast

Subscribe to:
POZ magazine
Newsletters
Join POZ: Facebook MySpace Twitter Pinterest
Tumblr Google+ Flickr Instagram
POZ Personals
Sign In / Join
Username:
Password:
Welcome, Guest. Please login or register.
December 21, 2014, 06:51:54 AM

Login with username, password and session length


Members
Stats
  • Total Posts: 650048
  • Total Topics: 49619
  • Online Today: 177
  • Online Ever: 585
  • (January 07, 2014, 02:31:47 PM)
Users Online
Users: 3
Guests: 127
Total: 130

Welcome


Welcome to the POZ/AIDSmeds Community Forums, a round-the-clock discussion area for people with HIV/AIDS, their friends/family/caregivers, and others concerned about HIV/AIDS.  Click on the links below to browse our various forums; scroll down for a glance at the most recent posts; or join in the conversation yourself by registering on the left side of this page.

Privacy Warning:  Please realize that these forums are open to all, and are fully searchable via Google and other search engines. If you are HIV positive and disclose this in our forums, then it is almost the same thing as telling the whole world (or at least the World Wide Web). If this concerns you, then do not use a username or avatar that are self-identifying in any way. We do not allow the deletion of anything you post in these forums, so think before you post.

  • The information shared in these forums, by moderators and members, is designed to complement, not replace, the relationship between an individual and his/her own physician.

  • All members of these forums are, by default, not considered to be licensed medical providers. If otherwise, users must clearly define themselves as such.

  • Forums members must behave at all times with respect and honesty. Posting guidelines, including time-out and banning policies, have been established by the moderators of these forums. Click here for “Am I Infected?” posting guidelines. Click here for posting guidelines pertaining to all other POZ/AIDSmeds community forums.

  • We ask all forums members to provide references for health/medical/scientific information they provide, when it is not a personal experience being discussed. Please provide hyperlinks with full URLs or full citations of published works not available via the Internet. Additionally, all forums members must post information which are true and correct to their knowledge.

  • Product advertisement—including links; banners; editorial content; and clinical trial, study or survey participation—is strictly prohibited by forums members unless permission has been secured from POZ.

To change forums navigation language settings, click here (members only), Register now

Para cambiar sus preferencias de los foros en español, haz clic aquí (sólo miembros), Regístrate ahora

Finished Reading This? You can collapse this or any other box on this page by clicking the symbol in each box.

Author Topic: Consequences of starting meds late  (Read 2173 times)

0 Members and 1 Guest are viewing this topic.

Offline newbie76

  • Member
  • Posts: 238
Consequences of starting meds late
« on: March 28, 2012, 05:07:11 AM »
Patient A started his meds when his CD4 was around 100.
5 years down the line his CD4 is 750 and he is undetectable.

Patient B started his meds when his CD4 was around 400.
5 years down the line his CD4 is 750 and he is undetectable.

Is patient A more likely to catch an OI than patient B, even though they have the same CD4 now? Why is that?

Thank you!
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline spacebarsux

  • Member
  • Posts: 1,350
  • Survival of the Fittest
Re: Consequences of starting meds late
« Reply #1 on: March 28, 2012, 07:22:46 AM »
Patient A started his meds when his CD4 was around 100.
5 years down the line his CD4 is 750 and he is undetectable.

Patient B started his meds when his CD4 was around 400.
5 years down the line his CD4 is 750 and he is undetectable.

Is patient A more likely to catch an OI than patient B, even though they have the same CD4 now? Why is that?

Thank you!

Hey,

Current scientific data tells us that there is a 'net-long term benefit' in commencing therapy prior to CD4 counts falling below 350 than with commencing treatment with counts lower than that, for example at 200 or lower.

The START clinical study is currently underway which will give us conclusive data on whether or not there is a 'net long term benefit' of beginning ARV's with CD4s>500. A lot of experts are of the view that people should start ARVs as soon as possible irrespective of CD4 counts, as HIV itself takes a toll on the body through chronic immune activation, inflammation etc, however, this view is grounded more on medical-expert opinion than on cohort clinical trial data.

That said, it is also my understanding that there are a host of other individual factors that come into play and thus starting therapy at CD4 100 rather than at 350, does not solely, nor necessarily translate to a greater likelihood of future AIDS related complications. As long as the viral load is suppressed and CD4s are healthy, there shouldn't be a cause for concern.
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline newbie76

  • Member
  • Posts: 238
Re: Consequences of starting meds late
« Reply #2 on: March 28, 2012, 07:49:05 AM »
Thank you for your reply!
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline mecch

  • Member
  • Posts: 12,166
  • red pill? or blue pill?
Re: Consequences of starting meds late
« Reply #3 on: March 28, 2012, 08:35:52 AM »
I understand there is a large variety of different kinds of CD4.  When HIV results in a CD4 wipe out, and the HAART is begun, immunity is repuilt but there were SOME varieties of CD4 that were wiped out, and can never be rebuilt.  One HIV+ person's 750CD4 may contain a large variety of cells. Another person's CD4 of 750 can be a small variety of cells.  Its the same total number of cells, but not the same variety of cells.  Maybe this means something.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline mikeyb39

  • Member
  • Posts: 948
Re: Consequences of starting meds late
« Reply #4 on: March 28, 2012, 12:55:42 PM »
I think i had one of the questions on an algebra exam
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
06/10/2011  cd4-447, vl-70
10/10/2011  cd4-666, vl-80
01/05/2012  swiched med (prezista,norvir ,isentress, )
02/10/2012  cd4-733, vl-UD  Viread removed
06/10/2012  cd4-614, vl-UD
12/14/2012  cd4-764, vl-UD
09/01/2013  cd4-785, vl-UD
03/06/2014. cd4- 1078, VL-UD
09/05/2014  cd4-850 , VL-UD

Offline spacebarsux

  • Member
  • Posts: 1,350
  • Survival of the Fittest
Re: Consequences of starting meds late
« Reply #5 on: March 28, 2012, 01:29:23 PM »
I think i had one of the questions on an algebra exam

Ive to say your school was very progressive, to have weaved in hiv treatment issues in its maths exam questions.  ;)
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline newt

  • Member
  • Posts: 3,887
  • the one and original newt
Re: Consequences of starting meds late
« Reply #6 on: March 28, 2012, 05:03:38 PM »
The answer to your hypothetical questions is no. Risk of OIs is highly correlated to CD4 count. Whether total exposure to the virus (a concept called cumulative viral load) makes a difference eg to risk of cancer is a proposed subejct of research. Also, age make make a (small) difference in recovery of immune function and therefore risk of illness (and cancer). This is not researched, just plausible.

Hope this helps

- matt
"The object is to be a well patient, not a good patient"

Offline newbie76

  • Member
  • Posts: 238
Re: Consequences of starting meds late
« Reply #7 on: March 30, 2012, 03:13:36 PM »
Thank you for all your replies.
Apologies for not checking this sooner but I have been admitted to hospital with Pneumonia since posting...
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline Hellraiser

  • Member
  • Posts: 4,143
  • Semi-misanthropic
Re: Consequences of starting meds late
« Reply #8 on: March 30, 2012, 10:06:21 PM »
Thank you for all your replies.
Apologies for not checking this sooner but I have been admitted to hospital with Pneumonia since posting...

Sorry to hear it, I hope you begin to feel better soon.

Offline newbie76

  • Member
  • Posts: 238
Re: Consequences of starting meds late
« Reply #9 on: March 31, 2012, 03:50:17 AM »
Thank you Hellraiser!

All the best.
25th Apr 07: The worst day of my life
27th Apr 07: cd4 202 14%
30th Apr 07: cd4 126 18% VL 110000
19th May 07: Started Truvada/Sustiva
20th Jun 07: cd4 218 25% VL 435
13th Aug 07: cd4 374 20% VL 64
20th Dec 07: cd4 435 24% VL <50
20th Oct 08: cd4 725 31% VL <50
30th Nov 09: cd4 725 30% VL <50
01st Nov 10: cd4 755 33% VL<50
11th Nov 11: cd4 754 32% VL<50
01st May 12: cd4 864 40% VL<50
01st May 13: cd4 615 VL 609 :-/
14th May 13: VL <50

Offline spacebarsux

  • Member
  • Posts: 1,350
  • Survival of the Fittest
Re: Consequences of starting meds late
« Reply #10 on: March 31, 2012, 03:57:01 AM »
Hope you feel better soon newbie! hugs
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

 


Terms of Membership for these forums
 

© 2014 Smart + Strong. All Rights Reserved.   terms of use and your privacy
Smart + Strong® is a registered trademark of CDM Publishing, LLC.