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Author Topic: Cells around 390. Skins problems appear. To start or not to start?  (Read 10982 times)

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Offline lifer

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hey guys i havent been on here for a while , hope everyone is doing well. I really need to hear your opinion in this.

so my last three labresults were 360, 440 en 390 just recently. VL around 40.000

my doc says its not necessary to start meds now and that we can probably stretch this for another 3 to 4 months. she says since im going to be on meds forever and im quite young (22), i might as well stretch this as far as i can. which is all fine bbuutt..


since a few weeks i am experiencing weird skin problems. bumpy pimples just pop out of nowhere on my jawline, back, legs and scalp. nothing really huge but theyre painful at times and ive already made an overhaul in my diet for WEEKS and yet cant find the culprit other than maybe HIV and especially the CD4 cells being on the lower side. Does this perhaps mean my immune system is crashing and its resulting in skin problems? Ive always been prone to acne but ive never had this before. usually when i would change my eating habits it would just dissapear. but now that i have and it still pops up and takes a much longer time to heal im starting to get worried. should i link this to hiv?
im seeing a derm on wednesday and im sure shes going to prescribe some kind of a topical treatment but somehow my intuition is telling me this wont be solved until i start taking meds (which in my case would be atripla, already discussed) and see my CD4 cells rise. its basically my call. if iw ant, i can be on atripla by the end of next week. what do you guys think? its scary to start the meds especially psychologically if this is how its going to be for the rest of the time that im off meds, then i might as well just be on it right?

i appreciate your opinion.
« Last Edit: April 02, 2010, 03:11:38 PM by lifer »

Offline lifer

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #1 on: April 02, 2010, 03:15:47 PM »
also what are the chances that this will go away as soon as im on meds? i mean, what if i develop another kind of a rash from atripla itself and will deal with this for weeks/months?

Offline kev72

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #2 on: April 02, 2010, 03:28:19 PM »
I have been having the same problems. My doctor checked me out and said once I start treatment mine will disappear. I have been on Atripla a few weeks, and still have these things. They are like acne and I look like shit. Not sure if its from the HIV, or the fact that my CD4 is low but its driving me crazy in my social life LOL

Offline PozBrian

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #3 on: April 02, 2010, 03:42:48 PM »
 I had those too. Kinda painful, kinda large, and deeper than acne I'd experienced before. They started about 3 weeks after I started atripla. They lasted a couple months but I haven't had any since last fall. My CD4 counts had been slowly going up and it may be more to getting a "healthier" immune system, My ID doc thought so anyway.  Not a problem for me anymore.
3/8 CD4: 495, 31%, VL UD
2/1 CD4: 564, 20%.VL UD, switching to Issentress & truvada
10/11 CD4: 446, 29%, VL UD
7/11 CD4: 873, 35%, VL UD
4/11 CD4: 573, 34% VL 0
12/10 CD4: 405, 30% VL UD
9/10 CD4: 416, 31% VL UD
5/10 CD4: 393, 29% VL: UD
02/10 CD4: 423, 37% VL: UD
11/09 CD4: 379, 25% VL: UNDETECTABLE!!
10/09 CD4: 245, 25% VL: 87
9/09 CD4: 246, 24% VL: 49!
8/09 CD4: 277, 26% VL: 115
7/09 CD4: 346, 24% VL: 221
6/09 started Atripla
5/09 CD4: 326, 16%  VL:125000
4/09 HIV +, CD4: 397, 16%  VL:195000, PPD reactive

Offline kev72

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #4 on: April 02, 2010, 03:54:23 PM »
Mine seemed to start up when I started the Bactrim and zithromax. I started the Atripla a week after starting those.

Offline lifer

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #5 on: April 02, 2010, 04:01:07 PM »
but see. thats the biggest worry that i have about starting atripla now. it might worsen it all at first before it will eventually clear up which might take months indeed. i might just take a minor antibiotic against acne then (minocycline) because i know that that does help since ive been on it before and it has helped a great deal. perhaps i should just wait and have the dermatologist take a look at it first...

Offline mecch

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #6 on: April 02, 2010, 04:17:35 PM »
Start your HAART now. What is the difference of a few months really. You'll have to commit then, so you can just as well commit now, and get on the road to better skin, to boot.

There is something called IRIS when you start - your skin could get worse for a few months. Or maybe you won't get immune reconstitution problems. 

It doesn't matter.  If you wait a few months, your skin problems stay, AND you still have the same risk of IRIS. 
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #7 on: April 02, 2010, 04:30:27 PM »
Lifer:

Remember that skin problems of the type you describe can occur at any time, to anybody, whether they have HIV or not. Many people who escape teenage acne are often horrified when it strikes them in their late 20s or 30s, but it's certainly not uncommon.

If you feel ready to start taking combination therapy then start now, and it might have the bonus of helping your skin clear up. But I wouldn't start it just to prevent further outbreaks as you could well be disappointed if that's not the way things work out.

Offline mecch

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #8 on: April 02, 2010, 05:07:51 PM »
I disagree with the last poster.
My bet would be your weakened and stressed immunity and the general inflammation that comes with active hiv is doing nothing good for your skin.  Furthermore, you are anxious about HIV.  Also as you say, its inevitable, says your doc.  So won't you get ease of mind knowing your virus replication is FINISHED.  Your mind and body will thank you. I think this will lessen your stress and generally you will be more chilled out, your immune system will reconstitute, and your skin will improve.
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline Nestor

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #9 on: April 02, 2010, 05:13:08 PM »

Hi Lifer,

Since people who are on meds have no shortage of problems, a skin problem doesn't sound to me like a very good reason to start HAART.  For everyone who says that as soon as he started HAART his problems melted away, there's someone who says that after starting HAART the problems stuck around or got worse. 

As for your numbers, they sound stable.  I will start HAART when it is clear that my numbers are in decline, not when they are fluctuating or basically stable.  What is your CD4 percentage?  I agree that if it were only a question of a few months, that wouldn't make a big difference.  But how do you know that you might not have many years left during which meds will not be necessary?  I agree with your doctor--five decades on atripla is not something to leap into lightly or needlessly. 

I think it's important to address the problem at hand on its own terms.   I had pretty bad dermatitis and I've largely solved it by improving my diet and taking evening primrose oil and cod liver oil.  You say that you made a major overhaul of your diet and it didn't help; that sounds to me like a sign that the overhaul may not have been complete enough.  Finding the right diet for you, and one that's balanced, is a long process involving trial and error and lots of going 'back to the drawing board'.  For a long time I thought I had the perfect diet for me, and then a couple of minor but annoying problems appeared.  That was a clear signal from my body that my diet was not as perfect as I thought it was and I needed to make some changes. 

 If you want to chat about what you're eating and what the problem might be, I would be happy to do that.  Getting enough sleep is also crucial. 

As for seeing a dermatologist, I went to one when I was having my dermatitis problems and I wish I hadn't bothered.  All she did was exactly what I knew she would do: she said it was dermatitis and she prescribed a cortico-steroid.  Those things solve the problem in the short term, but they do not solve the problem in the long term and they cause more problems, long term, than they solve. 

One thing that I cannot recommend highly enough is Chinese herbal medicine.  I have used it for a variety of problems over the years and I have never known it not to help.  And this problem of yours is exactly the type of thing it is good at dealing with. 

Good luck! 
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline lifer

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #10 on: April 02, 2010, 05:56:48 PM »
Thank you for your input Nestor and everyone else. As for my CD4 percentage, I don't know, I'd have to ask.

The thing that frustrates me the most is that I treat my body well nowadays, I cut down on smoking entirely, have limited alcohol intake to only once a week. Start my day with fruits and nuts.Drink shitloads of green tea. Cut down on sodas. Cut down on most dairy. Eat as healthy as ever that including hardly any meat except for grilled/roasted chicken. Work out 4 to 5 times a week. I cannot begin to tell you the radical changes I have underwent over the last couple of months. No junkfood, burgers and crap like that. And yet I don't get back the results I should be seeing after putting so much effort into this. All my friends who are the same age eat crap, smoke, go out and get away with everything and I am the one to be constantly worried about the right things to eat/ not to eat. And of course HIV. I guess all this is not really doing my stress levels any good. But I must not complain. I feel good, except for the skin thing I look ok too. I guess not seeing the results I am expecting to see sometimes kills the drive to continue doing the right thing. But I keep telling myself I must go on. It might take longer to see it but the reward will be there, right? (sorry, didn't mean to turn this into a venting post).

Offline mecch

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  • red pill? or blue pill?
Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #11 on: April 02, 2010, 06:06:56 PM »
since you have responded to all the people encouraging you to avoid starting, and not to me, who encourages you to start, since your doctor says its a matter of months anyhow, I am curious why you don't address this specifically.

ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #12 on: April 02, 2010, 06:25:56 PM »
I think this will lessen your stress and generally you will be more chilled out, your immune system will reconstitute, and your skin will improve.

It's misleading in the extreme to make specific prognoses about someone elses conditions, especially when it comes to an organ as large and complex  as the skin. There's a possiblity his breakouts may improve with treatment but no one  can say with any certainty whatsoever - not even a doctor - that this will definitely happen.

Offline mecch

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  • red pill? or blue pill?
Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #13 on: April 02, 2010, 06:38:57 PM »
thus the words "I THINK"  duh. Im no expert. Just giving some arguments for the other side. His doc says 2-3 months anyway.  
ďFrom each, according to his ability; to each, according to his needĒ 1875 K Marx

Offline BlueMoon

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  • Calling from the Fun House
Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #14 on: April 02, 2010, 06:43:51 PM »
I would say skin problem or not, your CD4 count warrants consideration of meds.  I would do it.  

Your doctor has it backward; since you hope to live for another fifty years or more, probably all of them on meds, a few more months now won't really matter in the long run.    
...................VL.....CD4.....%
-----------------------------------------
08/10-- ......<40.....290.....42
05/10-- ......<48.....290.....46
02/10-- ......<48.....481.....44
10/09-- ......<48.....277.....46
07/09-- ......<48.....300.....38
05/09-- ........51.....449.....39
03/09-- Added Isentress
02/09-- ........65.....299.....34
11/08-- ........62.....242.....40
08/08-- ........66.....212.....29
05/08-- ......202.....217.....27
03/08-- ....5210.....187.....21
02/08-- Began Truvada/Reyataz/Norvir
12/07-- 273,000.....157.....22
11/07-- 229,000.....209.....22
10/07-- Diagnosis

It's a complex world.

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #15 on: April 02, 2010, 07:30:47 PM »
thus the words "I THINK"  duh. Im no expert. Just giving some arguments for the other side. His doc says 2-3 months anyway.  

In 2-3 months his CD4 count might well have gone up.  Or fallen further. Again, nothing's certain. But breakouts alone seem like insufficient reason to start treatment.

Offline Moffie65

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #16 on: April 02, 2010, 08:43:44 PM »
Lifer, I donít know you yet, but Iím the one who wonít bullshit you and Iíll tell the truth, as has been my experience.  

I happen to be pretty much a fuzz ball, and Foliculitis is not only been one of my uninvited guests, but I still deal with it from time to time.  It really is a royal pain in the butt.  I keep on hand, soap that is only available from the pharmacy and can be gotten with a simple script.  This is the soap used before surgery and is medicated to remove all germs before any surgical procedure is done.  It isnít the brown stuff, but the clear liquid.  This is the ONLY thing that has had any effect on my outbreaks.

Now for the therapy.  I got news for you buddy, you will be on meds for the rest of your life, as your neat moniker states, and so to let your numbers get any worse is probably not a really good idea.  I did that, partly out of ignorance and partly out of the knowledge that I might be very allergic to some of the early medications.  Rebuilding your immune system is not, I say not, an easy experience, and isnít really a cake walk either.  Let me tell you a bit of a secret.  The life span of an immune cell is about 73 years, give or take a few.  The immune cells you built as a child are still present in your system, and this is why so many of us who are survivors are probably breast fed babies.  Donít know if that might be true, but certainly is fun to speculate.  Back to the pills.  The immune damage you create, while you wait a very short period of time, is time wasted.  Start the meds already.  It is good for your body and your life.  Plus, youíll have fewer of the rash outbreaks; I mark my word on that.  






P.S.  I didnít tell you that my outbreaks are very few now that I have been on meds for the last 16 years.  I still have them, but rarely.
« Last Edit: April 02, 2010, 09:16:29 PM by Moffie65 »
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline WillyWump

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #17 on: April 02, 2010, 08:53:13 PM »
Heya Lifer,

Regarding the skin probs...for about 3 months prior starting meds I had terrible spots appear on my legs and upper arms, they would come and go and itch and then scale over, they were the size of a pea. My ID doc didnt know what it was (scary) and sent me to a dermatologist. Dermatologist wasnt real sure what to diagnose it as so he called it psoriasis. anyways long story short, they went away almost immediately after I started meds and have never returned. Although I still have very slight scars (dark spots where the worst of them were).

So for me, my skin probs went away after starting meds.

-Will
POZ since '08

Last Labs-
6/3/14 CD4- 736, UD 34%
6/25/13 CD4- 1036, UD,
2/4/13, CD4 - 489, UD, 28%

Current Meds: Prezista/Epzicom/ Norvir
.

Offline Nestor

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  • What we love, we shall grow to resemble.
Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #18 on: April 02, 2010, 10:59:29 PM »

Hi again,

Several people are talking about your doctor's "few months" statement; the more I think about it, the stranger it seems to me.  The only case in which it would make sense would be one in which there had been steady, inexorable decline of CD4s.  In that case, being at 390 now, you could expect to be below 350 in a few months, and then to talk about starting meds really would be reasonable.  However, the three lab results you have told us about do not suggest decline, but rather stability.  Unless your doctor has a crystal ball, Buffalo Boy is correct: your numbers could just as easily go up in the next few months rather than down. 

The percentage really would be a helpful thing to know about. 

Now, it sounds as if you've done some great stuff with your life in the past few months.  I personally have no problem with meat and dairy, but quitting smoking and soda and junk food is certainly a great start.  Remember that "Rome wasn't built in a day."  Your body may even be going through "withdrawal" or shock!  Be patient, take long views, keep reading and investigating, and there should be a solution somewhere.  One good way to start--keep a food journal in which you write down exactly what you eat every day, including drinks, portion sizes (rough estimate) and so forth.  Maybe something will become obvious just from looking at the journal. 

One more thing--about the "shitloads of green tea" that you mention.  I have mixed feelings here.  On one hand, I love green tea; trying and enjoying new varieties of green or oolong tea has been one of my pleasures for years.  And there's no denying that green tea has loads of health benefits.  But it also has caffeine, and I cannot deny that in periods when I don't have any caffeine at all I sleep better at night and have more energy during the day.  I'm in one of my no-caffeine periods right now and I feel the difference.  However, I love the stuff and don't think I'll ever quit forever.  But who knows?  Another question--is there any sugar in all that tea?  If so, then that would definitely be something to cut out! 

Sometimes even good things we do have negative short-term effects.  For example: to use Chinese terminology, meat is a very "yang" food and sugar is very "yin".  Someone who eats a lot of meats and a lot of sweets is at least balancing it out, though obviously not in an ideal way.  Suppose such a person, deciding to live a healthier lifestyle, suddenly cuts out all the sugar, but goes on eating lots of meat.  (I've done that very thing.)  Cutting out sugar is obviously good in itself, but now there's a real imbalance that will wreck havoc in the short term.  If a meat-eater suddenly goes vegetarian but continues to eat lots of sugar, that will be even worse. 

Good luck!
Summer 2004--became HIV+
Dec. 2005--found out

Date          CD4    %       VL
Jan. '06    725    25      9,097
Nov. '06    671    34     52,202
Apr. '07    553    30      24,270
Sept. '07  685    27       4,849
Jan. '08    825    29       4,749
Mar. '08    751    30     16,026
Aug. '08    653    30       3,108
Oct. '08     819    28     10,046
Jan '09      547    31     13,000
May '09     645   25        6,478
Aug. '09    688   30      19,571
Nov. '09     641    27       9,598
Feb. '10     638    27       4,480
May '10      687      9    799,000 (CMV)
July '10      600     21      31,000
Nov '10      682     24     15,000
June '11     563    23     210,000 (blasto)
July  '11      530    22      39,000
Aug '11      677     22      21,000
Sept. '12    747     15      14,000

Offline tednlou2

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #19 on: April 03, 2010, 02:44:43 AM »
You've probably talked about this before and I never saw it-- How long have you been poz?  I'm just wondering if you were recently infected in the last year and could possible see a rise in CD4.  I would say follow your heart on what's best.   

About dairy, I hear so many (especially some celebrities) say dairy is just bad for ya.  Many docs say we need it for the Vit D and other nutrients.  Why is it so bad?   

Offline veritas

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #20 on: April 03, 2010, 06:36:25 AM »

Lifer,

Your numbers are within the guideline recommendations to start medications. To delay any further is really of no value other than to delay the inevitable. If you could delay for a few more years I might consider it, however your numbers say differently. Don't do any more harm to your immune system. Atripla is  easy to take (once a day) and will do wonders for your immune system. By delaying, you could see further decline in immune function causing other potential problems to arise. Your immune function will not get better until you start medication. Think about it.

v

Offline kev72

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #21 on: April 03, 2010, 06:52:52 AM »
Hey gang,

As far as the skin problems go, I have been going through the same problems as the poster. None of the doctors I went to gave me any real diagnosis on what it was and just told me to use a cortisone cream. I tried cortisone, Bactroban, Benedryl and nothing helped. The other day I found a tube of Dermator Prednicarbate Cream made by Aventis. I used it, and finally after going through hell with this stuff all over my face, under my eyes and on my farhead and behind my ears, within 2 days, the cream has worked. First the redness disappeared, then the pimple like things started to vanish. Thank God. If anyone is having these issues of folliculitis, you may want to google Dermator and tell you're doc to give you an RX.

As far as the medications go, I am on Bactrim, Zithromax, Flucozonal, and started Atripla a few weeks ago. I had this problem before starting the meds, and even with the start of Atripla, I did not get any better or worse, but I have only been on it for a few weeks.

Offline zielwolf

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #22 on: April 03, 2010, 01:12:23 PM »
Thank you for your input Nestor and everyone else. As for my CD4 percentage, I don't know, I'd have to ask.

The thing that frustrates me the most is that I treat my body well nowadays, I cut down on smoking entirely, have limited alcohol intake to only once a week. Start my day with fruits and nuts.Drink shitloads of green tea. Cut down on sodas. Cut down on most dairy. Eat as healthy as ever that including hardly any meat except for grilled/roasted chicken. Work out 4 to 5 times a week.

Hey there, I was until recently in a very similar situation as you. My CD4 counts weren't that bad, not quite as good as yours but they were steady, in fact slowly increasing rather than decreasing over the last year.
But my viral load was significant and my CD4 percentage was falling. And I was feeling trapped by this virus, unable to do anything about it.
Like you though, the last thing I did want to do about it was go on a program where I had to take pills every day for the rest of my life, if only because it would make everything real. To me swallowing those pills would confirm physically, not just on a lab report, but bodily and for the rest of my life that I have this thing and can never go back to how it was before (as if I could have anyway).

Before starting, I did all kinds of stuff to help my body fight the virus, all kinds of supplements, eating healthy, exercise, etc. but like the doctor predicted those had few, if any effects on my lab results.

Just last week, I finally, literally swallowed that "bitter pill", or two of them actually and then went to bed freaking out about the side effects that might follow. Well, they turned out not to be bitter at all. They turned out to be rather tasteless actually :)

I've been on HAART for all of one week now. All my worry was wasted energy. The only side-effects I've had are some mild bloating and more sleepiness than usual for all of 3 days. It's now day 7 and all the side-effects are gone. 7 days and I'm already totally used to swallowing them with my multi-vitamin pill which is the same shape and size (but different colour) and which I have been taking for years.

I wasted so much time and energy fretting and worrying about going on HAART and now that I've done it it's like "What was I thinking?". For the first time since I got diagnosed I finally feel like I am doing something to fight for my life, I can't feel them (hence the "tasteless" description) but I know these pills are right now as I sit here writing this, working to decimate and wipe out HIV in my body while I feel a whole lot better about my situation.

I know how you feel though, because just a week ago I was in exactly the same place as you are. One thing that changed how I thought about it was a comment by a doctor that read like this: "With any other infection, as soon as it's diagnosed we prescribe medicine to fight it; it's only with HIV that we wait and wait. If you have an infection and there is medicine available, why on earth wouldn't you take it as soon as you can?" (There's the side-effects issue of course, but if you're 22 & otherwise healthy it's probably not going to be one.)

Good luck with it.
« Last Edit: April 03, 2010, 01:14:01 PM by zielwolf »
03/10 VL >100,000, CD4 275
Started Viramune/Truvada
05/10 VL 606, CD4 438

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #23 on: April 03, 2010, 04:03:30 PM »
With your CD4 count currently around 390, starting treatment doesn't need to be rushed into just yet. If I were you I'd get a couple more counts done over the next 6 months and see what the general trend is then:

''Most guidelines now recommend treating anyone whose CD4 count is below 350 and cetainly before it falls below 200''

http://i-base.info/guides/starting/cd4-count-and-guidelines

Offline Moffie65

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #24 on: April 03, 2010, 07:17:32 PM »
Some of the posters in this thread are not qualified to give you advise, simply because they are denialists.  Lifer, this is the problem with getting advise on the internet anymore.  Some of us have the experience, and then some don't.  I cannot say anymore, but please beware of those that encourage you to ignore the fact that HIV is now in your body for life, and the damage it is doing without therapy is astonishing.  Please consider starting therapy NOW.

In Love.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #25 on: April 03, 2010, 09:30:52 PM »
Some of the posters in this thread are not qualified to give you advise, simply because they are denialists

And who exactly are 'denialists' in this thread? No one here is saying don't get blood counts or to forget about taking medication forever, just that there is no immediate rush, and even his doctor thinks he can hold of for a few months and doesn't need to start 'NOW'. Are you more qualified than his physician then?

As you will have seen in the link I posted, the official UK guidelines suggest starting treatment when the CD4 count falls to 350, and certainly before dropping to 200. Given that the OP is not yet in this position, your advice actually goes against professional thinking.

Offline megasept

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #26 on: April 03, 2010, 10:44:56 PM »
Some of the posters in this thread are not qualified to give you advise, simply because they are denialists

And who exactly are 'denialists' in this thread? No one here is saying don't get blood counts or to forget about taking medication forever, just that there is no immediate rush, and even his doctor thinks he can hold of for a few months and doesn't need to start 'NOW'. Are you more qualified than his physician then?

As you will have seen in the link I posted, the official UK guidelines suggest starting treatment when the CD4 count falls to 350, and certainly before dropping to 200. Given that the OP is not yet in this position, your advice actually goes against professional thinking.

right on! not so much for the medical advice (i'd probably vote for his starting meds now), but for calling out moffie for the whole listen-to-those-of-us-with-experience bait game! everybody has experiences. many newbies have knowledge to share with LT POZ. respect is a 2-way street.

-steven (aka   8)  megasept)

Offline Matty the Damned

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #27 on: April 03, 2010, 11:09:02 PM »
right on! not so much for the medical advice (i'd probably vote for his starting meds now), but for calling out moffie for the whole listen-to-those-of-us-with-experience bait game! everybody has experiences. many newbies have knowledge to share with LT POZ. respect is a 2-way street.

-steven (aka   8)  megasept)

Feh to those who want to turn every debtate into n00bs vs LTS. There are a goodly proportion of us who belong to neither faction.

That said there is shrill, ignorant quality to the some of n00b voices around here. They need to understand there is a difference between being attacked and being disagreed with.

MtD

Offline veritas

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #28 on: April 04, 2010, 05:54:40 AM »

lifer,

US guidelines for starting HIV therapy 2010:

http://www.thebody.com/content/art12720.html

Here's another discussion:

http://www.thebodypro.com/content/art54342.html

Here's the full UK recs:

http://www.aidsmap.com/cms1060354.aspx

Clearly there are benefits to starting early, however, it is your decision.

v

Offline Ann

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #29 on: April 04, 2010, 10:55:06 AM »
Feh to those who want to turn every debtate into n00bs vs LTS. There are a goodly proportion of us who belong to neither faction.

That said there is shrill, ignorant quality to the some of n00b voices around here. They need to understand there is a difference between being attacked and being disagreed with.

MtD

Well said, Matty. Thank you.

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Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #30 on: April 04, 2010, 12:57:22 PM »
''They need to understand there is a difference between being attacked and being disagreed with.''

I'm sorry, but calling people 'denialists' is being attacked. Why the need for name calling at all? It should be enough for someone to simply present their opposing argument without branding others with controversial names, especially when no one was pushing a 'denialist' agenda on this thread as far as I can see.


Offline Luke

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #31 on: April 04, 2010, 01:01:41 PM »
Feh to those who want to turn every debtate into n00bs vs LTS. There are a goodly proportion of us who belong to neither faction.

That said there is shrill, ignorant quality to the some of n00b voices around here. They need to understand there is a difference between being attacked and being disagreed with.

MtD

And there we have the usual crass and quite hypocritical ignorance of the clique.

Offline BrotherDavid

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #32 on: April 04, 2010, 06:44:44 PM »
Dermator Prednicarbate Cream made by Aventis.

Hello,

I am new to you're community and hope I am not imposing but I wanted to agree with the above poster on the Prednicarbate cream as a remedy for folliculitis associated with HIV. I am not a doctor, but from my experience, this was the only cure for this skin issue I was having. It worked very quickly after I had spent a month dealing with unsightly itchy red acne like swelling on my face and neck.

For what it's worth, this skin issue started after I already had an undetectable virile load.

David
« Last Edit: April 04, 2010, 06:47:09 PM by BrotherDavid »

Offline loop78

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #33 on: April 05, 2010, 06:22:51 AM »
For what it's worth. My experience is that my skin condition improved dramatically when I started meds.

I had been fighting a troublesome acne in my back, but also in my face, and had had a couple of sebaceous cysts since I became positive. All of that cleared itself a month or two after starting meds. However, that doesn't mean the same will  necessarily happen to you if you start meds.

Regarding your numbers, you seem to be somewhat stable a little below the new threshold for meds in the us, still above it if you use the European guidelines or the old US ones. Moderate viral load.

So probably meds are not far away in the future for you, but you can wait and see how numbers evolve if you want to.

The above could be slightly different if you knew your cd4%, ie: the lower it is, the more probable it is your skin condition is somehow related to immune activation and the more you would benefit in general of meds.

I'm sorry I cannot be of more help, in the end starting or waiting to see how things go it's still your call. Good luck, whatever you decide to do :)

Offline Forevergreen

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #34 on: April 05, 2010, 10:57:55 AM »
start your meds now.

the longer you wait, the more damage there will be to your immune system. you dont want your immune system to get too low b/c it'll be harder for it to recover. what difference will few months make in relation to having to take meds for the rest of your life?

Offline dixieman

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #35 on: April 05, 2010, 11:30:28 AM »
This is just my opinion... 40,000 viral load and a cd4 count beloww 500... I'd start my meds asap... but, thats just me and if your having skin problems... even with my cd4 count of 1658... I have problems with my skin... its like a constant battle... clears up and breaks back out... Good luck! in whatever you decide...

Offline adhoc

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #36 on: April 05, 2010, 12:35:56 PM »
Current Guidelines say 350 and I believe they are looking at increasing the current guidelines up to 500. If I'm wrong let me know I don't want t misinform. Regardless I would start more sooner than waiting and putting it off. The healthier you are the better the immune response is. If you are concerned about side effects they're not as bad as the first generation meds (the horror stories) and are tolerable. Most people like Atripla for the dreams they induce, they can be quite vivid. The biggest thing to watch for is depression on the atripla and the rash it may cause(I didn't get one from it) but I hear it goes away fairly soon. Also it is a combo pill so it costs less on co-pays and less hassle. As for the acne I have acne issues and the first thing I can say if it is problematic you need to see a dermatologist first and foremost. Then you can start looking for the cause. Many people get acne at all periods in life and it may or may not be "directly" related to HIV. It can be definitely aggravated by HIV. I have also heard some people have more internal issues (gut) and like me I have the skin issues. Don't mess with over the counter things as they can sometimes do more damage than good and  see your dermatologist first before using them. My dermatologist has me on Minocycline (partially my request) and clindamycin lotion. So far I can say Ive seen an improvement but not completely removed as of yet. But acne can be caused by so many things beyond hormones, bacteria, over oily skin, dry skin the list is endless. Just let your dermatologist know what you have and where you are number wise and they should be able to put something together for you.
Good luck


After posting I read MTDs post with the link to the body, good site but I stand corrected I guess the new guidelines have been raised.
« Last Edit: April 05, 2010, 12:41:23 PM by adhoc »
alea iacta est

Offline Miss Philicia

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #37 on: April 05, 2010, 12:51:22 PM »
Current Guidelines say 350 and I believe they are looking at increasing the current guidelines up to 500. If I'm wrong let me know I don't want t misinform.

As of last December the US guidelines were updated:

http://www.aidsmap.com/en/news/90025212-9B46-4408-A81B-AC8719FB6CDF.asp

So instead of recommending 350 as the cut off, they now say between 350 and 500.  Basically this means not to keep waiting until you're at 350.
"Iíve slept with enough men to know that Iím not gay"

Offline Hellraiser

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #38 on: April 05, 2010, 04:34:37 PM »
I actually had some pretty rough skin issues right before starting meds and then after starting meds they got dramatically worse.  However, now 5 months down the roads my skin is looking much much better.  I did recently go through a 2 week treatment of Tetracycline in an attempt to maybe root out any bacterially caused follicutlitis as my doctor was relatively stumped as to what was causing my issues.  Like Willy I also had some really painful sores that would get infected and eventually heal but have left a mark here and there.  On the whole though the skin issues have improved dramatically and in my case I chalk it up to the improved immune system.  With your numbers I'd say you're on the lower end of the suggested time to start meds so if you're prepared take the plunge.  What's stopping you really?

Offline elf

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #39 on: April 05, 2010, 08:29:17 PM »
I agree that 350 is late/low.
I was diagnosed at 353 and started taking meds the next day.
I really did not want to postpone it although doctors said it would be better
to wait for 30 days to see the viral dynamics.
Let's have a Kiki!

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #40 on: April 05, 2010, 08:54:47 PM »
''Current Guidelines say 350 and I believe they are looking at increasing the current guidelines up to 500. If I'm wrong let me know I don't want t misinform.''


''Doctors are learning more about the best way to treat HIV, but it is still not known for certain when is the best time to start taking HIV treatment.''
 
''If your CD4 cell count is 350 or below you are recommended to discuss HIV treatment with your doctor, and start treatment as soon as you are ready''

http://www.aidsmap.com/cms1230814.aspx

Offline adhoc

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #41 on: April 05, 2010, 11:24:11 PM »
Thanks Miss P.
I looked at a couple of the links. I went to the source and looked it up at the CDC as well.
Here is the link Ill add to the mix.
http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf This page is dated 12-1-09

It seems there is some difference between info out there. I saw Buffaloboys post and his link is updated as 2-4-10.  Personally from what I talked about with my Doc, they run by the what the CDC states. Unfortunately for me I diagnosed and started meds late and know first hand the problems of not starting while the immune system is intact. Regardless of the links the info is basically stating that anyone around 350 needs to start meds.

In regards to Aidsmap (which I do check as well) isn't it a UK/European based site? Not saying that they are wrong but they may not have the same bearing in the US.
alea iacta est

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #42 on: April 06, 2010, 09:44:18 AM »
There isn't a single answer on when to start treatment, only guidelines, which can vary depending on the country issuing them.

Offline Grasshopper

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #43 on: April 06, 2010, 10:14:20 AM »
April 5, 2010

San Francisco Endorses Starting HIV Treatment Immediately After Diagnosis

http://www.aidsmeds.com/articles/treatment_HIV_diagnosis_1667_18253.shtml

Offline Moffie65

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #44 on: April 06, 2010, 10:14:58 AM »
There isn't a single answer on when to start treatment, only guidelines, which can vary depending on the country issuing them.

........................................................or words of sage advise from those of us who didn't have a choice.

Personally, if I was newly infected, and knew what I know from experience, and the drugs are available and efficacious; I would have started HAART regardless of what my CD4s were, or what anyone else said.  Including the CDC  which was so corrupted during the Bush years, they have no clue what is real or unreal with HIV.  Sorry, just the facts man.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #45 on: April 06, 2010, 11:03:03 AM »
''Others experts argue that while newer HIV medications are less toxic than earlier regimens, the long-term effects of these new drugs remain unknown.

Jay Levy, MD, a San Francisco virologist with the University of California, was one of the first to discover HIV. Heís skeptical of the cityís new policy.

As he told the Times: ďItís just too risky.Ē ''


http://www.aidsmeds.com/articles/treatment_HIV_diagnosis_1667_18253.shtml

Offline Miss Philicia

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #46 on: April 06, 2010, 11:06:12 AM »
Thanks Miss P.
I looked at a couple of the links. I went to the source and looked it up at the CDC as well.
Here is the link Ill add to the mix.
http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf This page is dated 12-1-09

It seems there is some difference between info out there. I saw Buffaloboys post and his link is updated as 2-4-10.  Personally from what I talked about with my Doc, they run by the what the CDC states. Unfortunately for me I diagnosed and started meds late and know first hand the problems of not starting while the immune system is intact. Regardless of the links the info is basically stating that anyone around 350 needs to start meds.

In regards to Aidsmap (which I do check as well) isn't it a UK/European based site? Not saying that they are wrong but they may not have the same bearing in the US.

That is correct.  And they often, at a later date, change their recommendations to be in line with CDC recommendations.  Not always I guess, so we'll see.  But regardless, clearly there's a general move in the direction of what the CDC is saying because the latest generation of HIV medications has lower toxicity and greatly less side effects.
"Iíve slept with enough men to know that Iím not gay"

Offline Miss Philicia

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #47 on: April 06, 2010, 11:07:56 AM »
btw, someone in this thread seems to have an agenda, and it's not an official at the CDC
"Iíve slept with enough men to know that Iím not gay"

Offline buffaloboy

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #48 on: April 06, 2010, 11:16:31 AM »
''Personally, if I was newly infected, and knew what I know from experience, and the drugs are available and efficacious; I would have started HAART regardless of what my CD4s were, or what anyone else said.  Including the CDC  which was so corrupted during the Bush years, they have no clue what is real or unreal with HIV.  Sorry, just the facts man.''

This is great. For you. But everyone is different and not everyone wants to start treatment immediately after they have been diagnosed. In the UK, at least, doctors do not urge commencing anti-HIV therapy when the CD4 counts are around the 400 mark, unless HIV related symptoms are also diagnosed.

Until there is unequivocal evidence that commencing early treatment confers real and tangible benefits, I'd be surprised if the UK guidelines are updated any time soon, if only due to the additional financial burden it would place on the NHS.

Offline Moffie65

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Re: Cells around 390. Skins problems appear. To start or not to start?
« Reply #49 on: April 06, 2010, 11:24:59 AM »
Jay Levy, MD, a San Francisco virologist with the University of California, was one of the first to discover HIV. Heís skeptical of the cityís new policy.

http://www.aidsmeds.com/articles/treatment_HIV_diagnosis_1667_18253.shtml
Please read and quote the bulk of the article.  Shit, if I only listened to Dr. Levy, I would have been dead 10 years ago, which would have made you enormiously happy I suppose.

Damn, what is it with taking one sentence or quote from a doubter and basing all HIV suppositions on those?  For the rest of you who actually hold some respect for the quality of research coming out of the San Francisco department of health; please read the rest of the article, and start your meds already.  Damn this is becoming totally insane here on this forum.   :'(
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

 


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