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Author Topic: One month after starting treatment- strange numbers??  (Read 1957 times)

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Offline pozoz

  • Member
  • Posts: 71
One month after starting treatment- strange numbers??
« on: July 30, 2010, 07:54:19 AM »
Hi all,

Got my first labs after starting treatment emailed to me today, the numbers are a bit strange, or maybe not.

Doctor did not sound alarmed or concerned, and I'm unable to speak to him for a few weeks as he is officially on holidays as of today, fair enough.
 
Big improvement as far as viral load, it's gone down to 339.

My concern is CD4, it's now at 20%, 21% prior to starting treatment. And CD4 is now 360. Before it was five hundred and something. Also, creatinine was a little elevated, and it was suggested I drink more water. I already drink 3 litres a day.

Should I be concerned? Is this "normal"

Thanks all...Peace...

Seroconverted Aug 2008
Tested Pos      May 2009
May 09 CD4 544 19%   VL 22K
Aug 09 CD4 514  19% VL 25K
Dec 09 CD4 510  20% VL 32K
June10 CD4 502  20% VL 36K
July 5th,10 Start Truvada  Reyataz Norvir July 30  CD4 360  21% VL 339
Oct  22 CD4 459  27% VL 191
Jan 2011CD4 561 33% VL U/D <40
Feb  Add Verimune lead in dose to start switch to Verimune/Truvada  
Mar 17 Viramune x2 + Truvada. Stop PIs   
Apr 29     CD4 528 33% VL U/D
July 2011 CD4 440  %?  VL U/D
Sept 2011CD4 620  %?   VL U/D
Dec 2011 CD4 531 31% VL 224
Jan 2012  CD4 576 36% VL U/D
May 2012 CD4 504 36% U/D (start Viramune XR
July 2012 576 (36%) (test request due to XR issues)
Feb  2013 629  (? %) U/D
July  2013 608 38%.   U/D
Jan  14.    576  36%.   UD

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: One month after starting treatment- strange numbers??
« Reply #1 on: July 30, 2010, 09:08:33 AM »
See:

http://www.aidsmeds.com/articles/TCellTest_4727.shtml

Your results show that immunologic response is a bit slow but virologic response is fast.

depends on people. Seems that you can not have both at the same speed. Have a look at your CD8 as well,

I was a bit concerned because after 2 months under meds all numbers had nicely increased but my VL still at 700. I therefore felt very comforted by this statement:

most experts agree that once anti-HIV therapy is started, an increase in the T-cell ratio (i.e. a rising CD4 count and a falling CD8 count) is a telltale sign that drug treatment is working.

This is my case (base line ratio at 0.25, now 0.7) and I felt very happy after I read that post/link

My doc said that after one month, the total number of lymphocytes bounces a lot (hence the CD4 count since the percentage is almost the same)

Immunlogic response is the consequence of virologic response, therefore, it seems in the proper order of things to have virologic response first, then immunlogic. Once on meds, doc will look at VL at 1 month, 3 months, 6 months. Have to be UD after 6 months. Have to have an increase of CD4 after 6 months (the extend of that increase is not precisely defined). So for you, it seems OK...

Slow immunologic response is not a sign of poorer   immunologic response. there was a recent article on aidsmeds on this matter.

Hang on! Cheers!

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Online Miss Philicia

  • Member
  • Posts: 24,424
  • celebrity poster, faker & poser
Re: One month after starting treatment- strange numbers??
« Reply #2 on: July 30, 2010, 09:44:56 AM »
pozoz, if the numbers in your signature line are correct, then your post is incorrect -- your cd4% actually went up, not down -- from 20% to 21%.  While it would have been nicer if your absolute cd4 rose as well, it didn't.  As long as your % rose or stayed stable I'd dismiss the decrease in the absolute for now, as it can easily fluctuate +/-100 or so.

The bottom line is that your viral load decreased and will most likely be <48 (i.e. undetectable) by your next lab draw.  This indicates that the treatment is working.  You'll need to wait for a couple more lab draws to see any increase in the absolute cd4 possibly.  Please be patient and think long term.

As far as the creatine issue, and not knowing if it was way high or just slightly out of range, other than drinking water as instructed it's possible that your numbers will adjust and be back in range by the next lab draw.  If it's not then you can discuss what's going on with your doctor.  I've had that lab line be out of range and then go back to normal the next visit.
"Iíve slept with enough men to know that Iím not gay"

Offline pozoz

  • Member
  • Posts: 71
Re: One month after starting treatment- strange numbers??
« Reply #3 on: July 31, 2010, 07:13:53 AM »
Thanks very much to those who replied to my post. It was interesting and educational to read the links and hear from you.

As always this forum is a great source of information and support.

I guess sometimes we just need reassurance that things are happening the way they are supposed to, treatment wise anyway.

More bloods in 2 weeks ( Dr's suggestion) and have another look at the numbers.

Peace Out....

Seroconverted Aug 2008
Tested Pos      May 2009
May 09 CD4 544 19%   VL 22K
Aug 09 CD4 514  19% VL 25K
Dec 09 CD4 510  20% VL 32K
June10 CD4 502  20% VL 36K
July 5th,10 Start Truvada  Reyataz Norvir July 30  CD4 360  21% VL 339
Oct  22 CD4 459  27% VL 191
Jan 2011CD4 561 33% VL U/D <40
Feb  Add Verimune lead in dose to start switch to Verimune/Truvada  
Mar 17 Viramune x2 + Truvada. Stop PIs   
Apr 29     CD4 528 33% VL U/D
July 2011 CD4 440  %?  VL U/D
Sept 2011CD4 620  %?   VL U/D
Dec 2011 CD4 531 31% VL 224
Jan 2012  CD4 576 36% VL U/D
May 2012 CD4 504 36% U/D (start Viramune XR
July 2012 576 (36%) (test request due to XR issues)
Feb  2013 629  (? %) U/D
July  2013 608 38%.   U/D
Jan  14.    576  36%.   UD

Offline pozoz

  • Member
  • Posts: 71
Re: One month after starting treatment- strange numbers??
« Reply #4 on: July 31, 2010, 07:16:41 AM »
Hi all,

Got my first labs after starting treatment emailed to me today, the numbers are a bit strange, or maybe not.

Doctor did not sound alarmed or concerned, and I'm unable to speak to him for a few weeks as he is officially on holidays as of today, fair enough.
 
Big improvement as far as viral load, it's gone down to 339.

My concern is CD4, it's now at 20%, 21% prior to starting treatment. And CD4 is now 360. Before it was five hundred and something. Also, creatinine was a little elevated, and it was suggested I drink more water. I already drink 3 litres a day.

Should I be concerned? Is this "normal"

Thanks all...Peace...



Yea sorry I got the CD4 % backwards somehow, dyslexia maybe?..stress?..who knows... it happens...lol ???
« Last Edit: August 01, 2010, 06:52:31 AM by pozoz »
Seroconverted Aug 2008
Tested Pos      May 2009
May 09 CD4 544 19%   VL 22K
Aug 09 CD4 514  19% VL 25K
Dec 09 CD4 510  20% VL 32K
June10 CD4 502  20% VL 36K
July 5th,10 Start Truvada  Reyataz Norvir July 30  CD4 360  21% VL 339
Oct  22 CD4 459  27% VL 191
Jan 2011CD4 561 33% VL U/D <40
Feb  Add Verimune lead in dose to start switch to Verimune/Truvada  
Mar 17 Viramune x2 + Truvada. Stop PIs   
Apr 29     CD4 528 33% VL U/D
July 2011 CD4 440  %?  VL U/D
Sept 2011CD4 620  %?   VL U/D
Dec 2011 CD4 531 31% VL 224
Jan 2012  CD4 576 36% VL U/D
May 2012 CD4 504 36% U/D (start Viramune XR
July 2012 576 (36%) (test request due to XR issues)
Feb  2013 629  (? %) U/D
July  2013 608 38%.   U/D
Jan  14.    576  36%.   UD

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: One month after starting treatment- strange numbers??
« Reply #5 on: August 01, 2010, 05:23:31 PM »
Hi,

Actually I am impressed that you have such low VL. Most likely you are going to pass the virologic response intermediate end poing of <500 at month 4.

I have posted a surprising (and may be not so scientifically correct) discussion on this matter on my thread (viramune+ Kivexa).

You may want to confront your future lab numbers with the formula given there...

BTW, how old are you?

Have a good day

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline roy100

  • Member
  • Posts: 123
Re: One month after starting treatment- strange numbers??
« Reply #6 on: August 01, 2010, 06:15:45 PM »
I am surprised you needed treatment after such little time of seroconversion.
I am sure it took me 10 years to fully develop Aids.
I am still waiting for my 2ND labs test after 33 months of treatment with Kaletra -Truvada.
The Dr told me ding test before that time was just wasting money.
I feel a lot better since my cd 46 count.
In a week I shall get new results coming.
I am sure your numbers are fine after just one month, treatment has just started and it to soon to make any major conclusions.
Good Luck!
Diagnosed 18Th March 2010
March 30Th VL +100,000 CD4 46
CD8T  575 CD8 %60.6
On Truvada and Kaletra. . Remeron 15mg  and150 mg  wellbutrin xl for depression. Clonazepan 2 mg to sleep. Omeprazole 20  once a day.
July 17 2010 Vl 362 CD4 155, 6.4 %
CD8T suppressors 1482 CD8% 61.1
 Nov 16 2010: V l 937 CD4 188,10%
CD8T Suppresors 997 CD8%55.8
August 15th 2011 Vl UD, less than 40.
CD4:543(26.7%) CD8:887 (43.6 %) Ratio .61
Jan 14th,2012 ,less than 40.
CD4:478 (24.4%) CD8: 962 (49.1%) Ratio.50
June 2012 CD4 599, CD8 856 UD
Oct 2013 CD 702, CD 843 UD Ratio:.87

Offline pozoz

  • Member
  • Posts: 71
Re: One month after starting treatment- strange numbers??
« Reply #7 on: August 02, 2010, 07:16:42 AM »
Eric48, I'm 43. I look forward to reading your post, thanks.

I'm also pretty impressed with the VL numbers after just under a month on treatment, these are amazing drugs and I'm very thankful for them.

Roy100, I was feeling fine with no effects from the HIV itself. The decision to start treatment was based on advice from this forum, my own research, and the latest guidelines. I do realise there is a risk from the treatment itself, but strongly believe starting treatment sooner rather than later was the best option for me.

I'm hoping I made the right choice and saved further damage to my immune system by starting at at CD4 above (just) 500. Time will tell I suppose. Right or wrong, I've started and have not looked back.

I was given Atripla but returned the unopened bottle to my Dr and started the regime I'm on now. Some of the stories here scared the hell out of me and I wasn't prepared to risk some of the side effects from Atripla. Also my work schedule would have made it difficult to take Atripla due to the empty stomach requirements. 

I had some jaundice initially from my current meds, thankfully that has all but subsided. My eyes were a stained yellow colour, not a good look. Back to bright white eyes again and take my current meds all at one time, once a day with dinner. Too easy.

Your doctor who said it was a waste of money??

I had a similar experience with the hospital chemist dispensary person, who tried to lecture me when I picked up my meds for the first time. She said something to the effect of " this are VERY expensive medicine, that's why you only get a months worth the first time" Needless to say I was extremely offended and politely (but fuming inside) explained that the cost of this medication is none of your concern, your job here is simply to dispense medication as stated on the form. Where I live, these meds and all bloods and Dr visits are covered 100% by the government, another reason to be thankful. What I wanted to say   was " "Look lady, I know you're in a shit paying job and probably having a crap day,  and I'm pretty sure I paid more in income tax last year than you probably earned". But I kept my cool and let it go. It annoys me that money comes into the picture but I guess that's the reality of life these days.

Best of luck to you, and thanks again for the replies...



Seroconverted Aug 2008
Tested Pos      May 2009
May 09 CD4 544 19%   VL 22K
Aug 09 CD4 514  19% VL 25K
Dec 09 CD4 510  20% VL 32K
June10 CD4 502  20% VL 36K
July 5th,10 Start Truvada  Reyataz Norvir July 30  CD4 360  21% VL 339
Oct  22 CD4 459  27% VL 191
Jan 2011CD4 561 33% VL U/D <40
Feb  Add Verimune lead in dose to start switch to Verimune/Truvada  
Mar 17 Viramune x2 + Truvada. Stop PIs   
Apr 29     CD4 528 33% VL U/D
July 2011 CD4 440  %?  VL U/D
Sept 2011CD4 620  %?   VL U/D
Dec 2011 CD4 531 31% VL 224
Jan 2012  CD4 576 36% VL U/D
May 2012 CD4 504 36% U/D (start Viramune XR
July 2012 576 (36%) (test request due to XR issues)
Feb  2013 629  (? %) U/D
July  2013 608 38%.   U/D
Jan  14.    576  36%.   UD

Offline eric48

  • Member
  • Posts: 1,202
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: One month after starting treatment- strange numbers??
« Reply #8 on: August 03, 2010, 05:32:54 AM »
Hi,

Were I live, where you live, meds and stuff are covered by social security (insurance). I have paid SO MUCH premiums through all my professional life, (I am still a net contributor to the insurance system despite the cost of treatment). This money is not coming from Govt or charities. It is coming from my WORK.

This is something I have made very clear to my doc from day one, as I do not want him or any other to even engage along that path. Docs and medical staff come across a mixed bag of people, and they sure have to be ressources aware. They are ways of getting that message to people in a polite and understanding fashion. and vice versa...

Cheers

Eric 
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: NCT02157311 = 4d. ON, 3d. OFF)

Offline pozoz

  • Member
  • Posts: 71
Re: One month after starting treatment- strange numbers??
« Reply #9 on: August 03, 2010, 09:27:30 AM »
Eric,
I was polite. I kept my smile and didn't say what I wanted to. I also continue to contibute to the tune of around 38% tax on my income, which more than covers the $20,000 or so that my meds are costing the PBS per year.

All I was saying, and I stand by my comment, is that the financial side of treatment is not the concern of someone who is employed to dispense medication to those such as us who are receiveing it.

If I had to explain in a "understanding fashion" to a person who is employed to receive my prescription, pass it on to the chemist, then give the medication to me, I think the person making such irrelevant comments about cost is in the wrong job.

Cheers mate, best of luck to you....Peace...
Seroconverted Aug 2008
Tested Pos      May 2009
May 09 CD4 544 19%   VL 22K
Aug 09 CD4 514  19% VL 25K
Dec 09 CD4 510  20% VL 32K
June10 CD4 502  20% VL 36K
July 5th,10 Start Truvada  Reyataz Norvir July 30  CD4 360  21% VL 339
Oct  22 CD4 459  27% VL 191
Jan 2011CD4 561 33% VL U/D <40
Feb  Add Verimune lead in dose to start switch to Verimune/Truvada  
Mar 17 Viramune x2 + Truvada. Stop PIs   
Apr 29     CD4 528 33% VL U/D
July 2011 CD4 440  %?  VL U/D
Sept 2011CD4 620  %?   VL U/D
Dec 2011 CD4 531 31% VL 224
Jan 2012  CD4 576 36% VL U/D
May 2012 CD4 504 36% U/D (start Viramune XR
July 2012 576 (36%) (test request due to XR issues)
Feb  2013 629  (? %) U/D
July  2013 608 38%.   U/D
Jan  14.    576  36%.   UD

 


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