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CD-4 Count and health

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clarke:
Does anyone know or understand the correlation between one's CD-4 count and how their health stays?

Mine is around the 500+ mark (I believe that's half of "normal"?), and has been for several years, and my VL has been undectable for over 6 years.

Viramune, AZT, Neurontin, Elavil (25mg. at night only) and Lorazapam (2mg. at night only).

I find myself still easily catching some kind of flu/cold, that from trial and error, Levaquin seems to be the only medicine to help.  Also, it seems my neuropathy is getting worse.
I have it in my feet, ankles and halfway to my knees.  I've been having a lot of hassle with my left leg the last month or so.  My MD did what tests she could, and also saw my left leg seems to have gotten worse as opposed to my right leg (I see a Neurologist later on this month).

My neuropathy seems really "weird" as opposed to what I've heard from other people with this.  The soles of my feet cannot feel the heat from sand at the beach, but when I touch them to put on my socks, trim nails, it hurts.  I've broken toes and my left ankle and not know it until I see the color of them at the end of the day.  It also seems my feet are extremely sensitive to cold but not heat (although heat "feels" good but doesn't hurt).  I've also got more than half a dozen warts on the my soles.

It seems though that when I see an MD when I get ill, they comment that my CD-4 count is good, and they don't understand why I get sick or why my neuropathy is getting worse. 

I understood from something I read year ago, that having a "good" CD-4 count means squat.  It said something that even though one may have a high CD-4 count, they aren't the same ones that the virus has and is wrecking, so they don't have the "memory" the original ones had to prevent or help the body when ill.

Anyone got an idea?

Much thanks,
clarke

cubbybear:
Clarke, there's no real answer to this, as the correlation of your health vs. cd4 count would be different to mine and everyone elses.

Some people do quite well on low CD4 counts, and seem to not pick up bugs, whilsts others with high CD4 counts seem to pick up everything that goes around.  There really is no direct answer.  On paper it all looks good that the higher CD4 counts are ideal, but in practice it's really very different.

You touched on the memory T cells in your last paragraph and yes that's true.  It can take a very long time to replace cells that remembered what type of antigens they were programmed for if they were destroyed by HIV.  If you lose those cells, you body will take a lot longer to fight disease than if those cells were available, as they would instantly identify what they were programed for and pump out the required antibodies.  With those gone, that step doesnt occur and cells need to be reprogrammed to remember what the body has come in to contact with again.

At least that's my limited knowledge of the immune system's memory t cells action in laymans terms.

newt:
CD4 of 300+ is basically well fuctional and sufficient, 500+ is normal (statistically normal for the US).  Disease progression is correaltated with viral load and CD4 count independently, viral load under 50 good, CD4 higher = better.

PN wise, perhaps get off the AZT (and why are you only on two anti-HIV drugs? - though they seem to be doing the rick eh, which is the real test...).  However, it doens not sound like typical HIV med realted neuropathy.  PN can have many causes.  Maybe this is related to the warts (eg a virus besides HIV causing some kind of local nerve damage).

- matt

AlanBama:
Hey Clarke.

You did a good job of describing neuropathy.   I always have trouble making people understand how something that is supposed to be 'numb' can have so much pain associated with it....I would routinely end up with a black toenail from jamming my toes down into my shoes and not realizing it.   I'm glad to say mine has gotten much better. (first developed in 1992)

Coincidentally, my left leg is also much worse than my right; worse vericose veins, worse edema, more pain....It probably all stems from me having a blood clot in that leg and the resulting DVT.   It's compression hose for me these days...

Good luck! and sending you hugs and positive energy....

Alan

Maestro:

--- Quote from: newt on September 08, 2006, 09:13:58 PM ---CD4 of 300+ is basically well fuctional and sufficient, 500+ is normal (statistically normal for the US).  Disease progression is correaltated with viral load and CD4 count independently, viral load under 50 good, CD4 higher = better.

PN wise, perhaps get off the AZT (and why are you only on two anti-HIV drugs? - though they seem to be doing the rick eh, which is the real test...).  However, it doens not sound like typical HIV med realted neuropathy.  PN can have many causes.  Maybe this is related to the warts (eg a virus besides HIV causing some kind of local nerve damage).

- matt

--- End quote ---

Newt,

When you say that progresiion is correlated independently, what does that mean?  My Uncle has a CD4 in the 140 range and currently a VL of 600 (though it was previously undetectable).  He tells me he has the low CD4 count for a long time.  He very recently swithced from Viread to Invirase and the dr. said the rise could be while the new meds work its way in.  Whatever the VL, he seems to have very low CD4 cells.  He has had pneumonia twice in the past 6 years (one PCP and 'regular'). 

He does seem to be getting sicker more frequently lately.  Would it be logical to correlate the low CD4 with the health issues?  And if so, is this what is clinically defined as 'progression'.  I seem to read a lot of literature that says AIDS is defined by a CD4 count under 200 and having had one of a list of opportunistic infections (which he has had).  Is this still the current guidlines?  Does this mean he has AIDS?

I really appreciate all the help.  I am so new at this and it is really a rollercoaster ride.  One day I think he is dying, the next he seems relatively fit.  Very stressful on both of us.

Thanks for everything..
Maestro

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