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Author Topic: My viral load is undetectable, but my CD4's are low. How do I get them up?  (Read 5682 times)

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Offline ilovelifetoo

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  • Posts: 2
My viral load after a year and a half are finally in January of 2010, undetectable. Hooray!! I look and feel healthy, but my CD4's are still low, at 128. What's the best way to get those to increase? No one seems to be able to give me a good answer. Can you help? It's probably just living healthy, eating right, getting enough rest, making sure that I take my meds, etc. Any suggestions?
Signed,
I love life too
 ???

Offline mecch

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  • red pill? or blue pill?
Hi welcome to forum. You'll need to post more details on your HIV infection.
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline leatherman

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  • Google and HIV meds are Your Friends
It's probably just living healthy, eating right, getting enough rest, making sure that I take my meds, etc.
welcome to the forums!

basically that's about all you can do.  ;D You probably never had your tcells measured before becoming poz and therefore don't even have a baseline to judge your current level by. Most people don't, so it's always going to be hard to tell if they've gone back up to normal or not, since you don't know what normal is. :D And although having more if preferrable, don't sweat it too much. I've lived 18 yrs with AIDS and an average of only 176. I've only topped 300 twice (305, 311). I haven't been back in the hospital in 12 yrs, so it's not always about how many you have but about how well they work. ;)
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Oh my friends, my friends forgive me
That I live and you are gone.
There's a grief that can't be spoken.
There's a pain goes on and on.
Empty chairs at empty tables
Where my friends will meet no more.

"Empty Chairs at Empty Tables" from Les Miserables

Offline decayingsinner

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  • Posts: 274
First off... welcome to the forums!  This is a great site to turn to for a great deal of info regarding HIV/AIDS.  I was diagnosed in 2008 and since then have been undetectable pretty quickly after becoming diagnosed.  My cd4 was at around 250 and in almost two years... has gone up to about 350.  Don't feel bad.   I feel great. It's a slow, steady climb.  I'm learning.  As you said, adequate sleep and a good diet have made a good impact on my numbers.  Good luck and welcome!

Offline veritas

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Ilovelifetoo,

Recent studies have found that there is growing evidence that those who begin treatment with cd4s of less than 350 , that it takes longer for the cd4s to recover to normal range. This does not mean they will not recover, it just means that it will take longer. What mikie and sinner said above is good advice ----take your medications as directed, get adequate sleep,  exercise and healthy eating.

Welcome to the forums !

v

Offline leatherman

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  • Google and HIV meds are Your Friends
Recent studies have found that there is growing evidence that those who begin treatment with cd4s of less than 350 , that it takes longer for the cd4s to recover to normal range. This does not mean they will not recover, it just means that it will take longer.
but that also doesn't mean that your cd4s will ever recover to a "normal range", hence my try not to sweat it too much advice.  ;)

In 1993 I started on AZT monotherapy for 9 months with no idea of my tcell counts. However in 1996 when I ended up hospitalized with PCP, I had a cd4 count of 5. Through the years I've had counts like 7,12,24,64,78. I would imagine that starting different regimens with such low counts is why I feel elated just to have counts above 200 these days.

It's obvious that you started onto meds with a fairly low count, if they have gone up and are still at the low mark of 128. If you had gone a long time ill with HIV and untreated, it's quite possible you won't ever see a big gain in your tcell number. I know a yr and a half may seem like a long time but consider that if you have been infected for 7-10 yrs how much unseen damage was happening to your immune system in that time. It could possibly take several years to see a gainful reverse in that damage.

But then again perhaps your immune system wasn't so damaged and you'll get a big jump in your counts in this next year now that the HIV has been suppressed to UD. The best way to judge the number is by the trend over several tests, which means it takes time.

and as to you original question, there's really nothing but healthy living - and having a good positive attitude about life - that you can do to up your tcell count, and even that's no guarantee. I'm the healthiest I've been in a decade, eat right, take my meds, exercise, swim, bike ride, hike. yet my last tcell count was 209. (I'm having bloodwork done today myself. and i'll know in about two wks what my counts are. I sure don't expect to see them jump to 400, so if they are still in a 200-250 range, then they'll be normal (for me) and I'll try to happy about it.)

hope all that helps!
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Oh my friends, my friends forgive me
That I live and you are gone.
There's a grief that can't be spoken.
There's a pain goes on and on.
Empty chairs at empty tables
Where my friends will meet no more.

"Empty Chairs at Empty Tables" from Les Miserables

Offline veritas

  • Member
  • Posts: 1,408

mikie,

Thanks for the correction. Your right, sometimes the immune system doesn't recover, if so, lets hope the cd4 stimulator Il-7 will take care of that after completing clinical trials (of course).

v

Offline leatherman

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  • Google and HIV meds are Your Friends
lets hope the cd4 stimulator Il-7 will take care of that after completing clinical trials (of course).
agreed!  ;D
although I can make the case for "it's not how many; but how well they work", I'm sure my poor pitiful 209 tcells would be overjoyed (to get stimulated! ROFL) to have some buddies helping ease the load.  ;) It would sure make me happier, and less fearful everytime I hear someone sneeze in the grocery store, if I had counts around say 600. ;D
leatherman (aka mIkIE)


chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Oh my friends, my friends forgive me
That I live and you are gone.
There's a grief that can't be spoken.
There's a pain goes on and on.
Empty chairs at empty tables
Where my friends will meet no more.

"Empty Chairs at Empty Tables" from Les Miserables

Offline Fondoo

  • Member
  • Posts: 72
There is allot of talk online these days about intestinal health being important for the immune system. Folks are recommending minimal antibiotic usage, regular probiotics,eating fermented foods ect..You might want to look in that direction
  Best Wishes
            Tracy

Offline jcelvis

  • Member
  • Posts: 77
You should look into cutting your sugar intake. Sugar is not bad, but if you're american, we eat WAY to much of it. It's in everything you buy, so if you eat a lot processed food it's probably loaded with sugar.

Just on a side note. I use to eat a lot of processed food and suffered from bad heartburn, and i started cooking my own food, and eating a balanced diet and i haven't had heartburn for 5 months.

If you have problems eating healthy food try incorporating something you like with something healthy that you want to start eating. When you eat something enjoyable it triggers the happy feelings, and it makes the less appealing foods more appetizing.
Change the way you view the world, and the world around you changes.

Offline pointer165

  • Member
  • Posts: 39
I have been living over 2 decades with HIV and I have seen so many "medicine doctor" answers to this guestion, that I laugh NOW!...I have had the same range for that amount of time..my doctor is pleased that I am undetectable...and I know that when I range between 150 to 300 I am OK!..never been higher than that when I first checked in 1988.


Cheers...
Tony(NYC)
Guamanian

Offline ilovelifetoo

  • member
  • Posts: 2
Hello my friends,
Thanks for your loving replies. Keep them coming. I feel like my question is an important one. I feel better now that I realize that I'm not alone. I'm feeling good. My endurance and strength are not what they used to be. I take naps and rest a lot, but there's nothing wrong with that, and it's not because I'm depressed.
Thanks again, keep the suggestions coming!
I Love life too

Offline allanq

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  • Posts: 687
  • still life with pills
I'm not sure that there is much you can do to raise those CD4s. I went for many years in the low double digits. My viral load became undetectable about six years ago, and my CD4s over the last few years have gone up and down in the 140 to 220 range.

Despite the low CD4s, I feel good and have not had any opportunistic infections, other than a bad case of molluscum when my CD4s were around 20. That cleared up after my viral load became undetectable and my CD4s improved to around 75.

I eat well, exercise, and get plenty of rest. I don't know what else I can do, so I just focus on keeping my VL undetectable, rather than worry about my CD4s.

Allan
Top (Breakfast): Prezista, Norvir, Isentress, Zoloft (2), Glyburide (2), Aspirin
Bottom right (Dinner): Prezista, Norvir, Isentress
Bottom left (Bedtime): Sustiva, Trazodone (2), Lipitor, Septra
Center: Alprazolam (Xanax)
Not shown: various vitamins & supplements

Offline Inchlingblue

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  • Posts: 3,119
  • Chad Ochocinco PETA Ad
There are several clinical trials looking at adding Maraviroc for people with virological suppression who have suboptimal T-cell recovery. Below is a link to one of them but if you go on clinicaltrials.gov and search "maraviroc CD4" a lot of others come up.

I also agree with some of the others who have mentioned adding probiotics and other supplements. Even though it has not been proven through a clinical trial, there is anecdotal evidence to suggest that probiotics as well as selenium have helped with CD4s.

LINKS:

Safety and Effectiveness of Addition of Maraviroc to ART Regimens in HIV-Infected Adults With Suboptimal CD4 T-Cell Count Recovery Despite Sustained Virologic Suppression

http://clinicaltrials.gov/ct2/show/NCT00709111?term=maraviroc+cd4&rank=1

http://clinicaltrials.gov/ct2/results?term=maraviroc+cd4

http://clinicaltrials.gov/ct2/results?term=t-cell+recovery

Offline hotpuppy

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  • Posts: 555
My experience was that it took time and that you need to eat healthy and be good to your body.  Specifically, this means not being drunk 6 nights a week while partying like there is no tomorrow.

I was in a clinical trial of Vicriviroc, which like Mariviroc is an entry inhibitor.  It worked well for me but my CD4's didn't climb as fast as I would have guessed.  More amusingly, they continued to climb after I stopped taking meds. 

In order to use entry-inhibitors you need a R5 tropic virus.  The only way to tell is to have a tropism assay done.  This is sometimes called a trofile and it's not cheap.  Your insurance might cover it, but check to be sure.  If you have dual tropism (x4 and r5) or X4 only virus you cannot use entry inhibitors.  Studies have indicated that individuals with X4 tropic infections have lower CD4s than those with R5.  It's not the end of the world, just a class of meds that will not help you.

There are some significant unknowns with blocking CCR5.  Specifically, we do not know what the normal role of the R5 receptor is.  The informed consent for Vicriviroc indicated that there might be an increased risk of cancer by using an entry inhibitor.  I would encourage you to discuss your treatment options with your doctor to make sure that entry inhibitors are right for you.  There is alot of good material out there that you can read to have a more informed conversation with your doc as well.

On another note, how long have you been undetectable?  It may take several months before your CD4's begin to rebound.  :)
Don't obsess over the wrong things.  Life isn't about your numbers, it isn't about this forum, it isn't about someone's opinion.  It's about getting out there and enjoying it.   I am a person with HIV - not the other way around.

Offline Inchlingblue

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There are some significant unknowns with blocking CCR5.  Specifically, we do not know what the normal role of the R5 receptor is.  The informed consent for Vicriviroc indicated that there might be an increased risk of cancer by using an entry inhibitor.  I would encourage you to discuss your treatment options with your doctor to make sure that entry inhibitors are right for you.  There is alot of good material out there that you can read to have a more informed conversation with your doc as well.

 

It's good that you bring this up and although it could be argued that more studies are needed in order to say definitively whether or not CCR5 antagonists might increase the risk of cancer, there's no evidence to suggest that they do (while a link does exist between low CD4s and a higher risk of diseases, including certain cancers).

Clinical Trials must make participants sign all sorts of disclosures for legal reasons, this should be taken with a grain of salt and put into the right perspective when deciding the merits of any given trial.

I'd knock out my CCR5 in a New York Minute if it meant getting rid of HIV and I look forward to stem cell therapies that are aiming to do just that.


CCR5 Antagonists in the Treatment of HIV-Infected Persons: Is Their Cancer Risk Increased, Decreased, or Unchanged?

This article examines 3 sources of data regarding the cancer risk with the use of CCR5 antagonists in HIV-infected patients: basic science research concerning the role of CCR5 in cancer pathogenesis, epidemiological studies of cancer rates in patients with congenital lack of functional CCR5, and clinical data of cancer rates in CCR5 antagonist studies. Available preclinical evidence suggests that CCR5 is critical to the development and progression of certain tumors and that, at least theoretically, blocking CCR5 seems unlikely to increase cancer risk. Epidemiological data in non–HIV-infected persons do not show a significantly different rate of the delta-32 mutation in persons with several different malignancies compared with matched controls without malignancies. In fact, persons with HIV infection and the delta-32 mutation appear to have a decreased risk of NHL.

Finally, while the available clinical data from trials of CCR5 antagonists show that malignancies have developed in patients in the treatment arms, they do not demonstrate a cancer risk that is significantly different from that in patients in the control groups. Given that development of malignancies is typically a long-term process, and only 2 of the studies of CCR5 antagonists have published data extending beyond 48 weeks, long-term studies are needed to more definitively establish whether CCR5 antagonism reduces, increases, or has no effect on cancer risk


LINK:

http://theaidsreader.consultantlive.com/display/article/1145619/1419085?pageNumber=2


In order to use entry-inhibitors you need a R5 tropic virus.  The only way to tell is to have a tropism assay done.  This is sometimes called a trofile and it's not cheap.  

The clinical trial looking at Maraviroc for the purposes of raising CD4s does not require R5-tropism. It's not a trial that will be looking at Maraviroc's effect on suppressing HIV but rather to try and confirm if Maraviroc raises CD4s since this has been seen to happen in other smaller studies as well as anecdotally

LINK:

http://clinicaltrials.gov/ct2/show/NCT00709111?term=maraviroc+cd4&rank=1
« Last Edit: February 03, 2010, 08:20:57 PM by Inchlingblue »

 


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