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Author Topic: Some good news...  (Read 2150 times)

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Offline Valmont

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Some good news...
« on: January 11, 2012, 03:52:08 PM »
Wow, this year seems strating really good, I have some important news I wanted to share with you...

1- My wife finally done her HIV test this week, in regard with the papers we are asking for a permanent visa to Canada, and it came back as a negative.  This ends more than 6 terrible months with stress and so on...  By the way, my son should also be negative...

2- I received my results, CD 714 and VL 95.000; it is better than June results: CD 509 and VL 176.000.  I donīt have % CD4, labs never do them because here "docs donīt use it"....

One question by the way, my VL is still very high I believe, do you think it can decrease more?  Should I start a treatment? (mmmm CD is really good).  For my application to Canada, these results can help me...  What do you think of them?  I havenīt seen VL so high with CD 4 so high before in the forum...   Anyway, next monday I will go to my doc...

3- My neck nodes have desapeared...

4- Iīve been selected in our second regional Rugby team as a titular...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline newt

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Re: Some good news...
« Reply #1 on: January 11, 2012, 06:38:26 PM »
Meds will knock your viral load on the head quickly, nothing else will.

There's nothing mystical about your high CD4 and modestly high viral load, it's often seen.

Good luck with Canada.

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

Offline Valmont

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Re: Some good news...
« Reply #2 on: January 11, 2012, 08:24:41 PM »
mmmmmm, I was thinking...  Iīve received 3 shots at the beginning of december, around 20 days before blood sampling.  Do this could have increased VL?

In guideline, for being acceptable for Canada, it is needed CD4 more than 500 and VL less than 55.000.  Actually, in regard with these guideline, I should not be acceptable for a permanent visa to Canada...  It is in French, sorry...

http://www.aidslaw.ca/FR/themes/documents/CIC_OP2002-004-FR.pdf

http://www.aidslaw.ca/publications/interfaces/downloadFile.php?ref=1930



In another way, Iīm now convinced I should start treatment as soon as possible in case my CD 4 number gets less than 500, but about VL, I donīt have many idea what I should do...  My health is before any visa and Iīm not sure it is so good to keep a high VL many time, Iīm also aware that only medication can really cut it down... mmmm.   This can wait 6 months more????
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline Since2005

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Re: Some good news...
« Reply #3 on: January 12, 2012, 01:46:23 AM »
Valmont, I am so happy for you!!! Finally, it happened!! What I am reading from your thread is that your wife is HIV negative? right? Well, that's great news!! And that's what you meant by that then your son doesn't need the testing right? If that's the case, GREAT NEWS! What a relief. I think you feel great about the whole situation then!! WTG..

For Canada immigration concerns, I wish you the best luck. Last time I checked, if your wife is qualified to be Canadian permanent immigrant, and if she is HIV neg, then it doesn't not matter if you are poz or not. Are you the main applicant? If that's the case, then you may have a little barrier on that issue. I can't read French, its look like the link that you provided has the year 2002 -2004. Is that right?

I never hard of any restrictions on the cd4 and VL count. They look into the fact that if your disease has any risks to public health and cause a burden to govt. healthcare ( unfortunately HIV counts to be one of them in Canada). I never hard of the cd4 and VL issues because then you still have the potential due to HIV meds costs can cause a burden to Canadian govt. (unfortunately). Now, if you could have your wife be the main applicant then that will eliminate the issues. I would check on the HIV issue through an experienced immigrant lawyer. Keep us updated. Again, congrates and good luck!!

Since
« Last Edit: January 12, 2012, 02:16:04 AM by Since2005 »

Offline Joe K

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Re: Some good news...
« Reply #4 on: January 12, 2012, 12:46:31 PM »
Hey Val,

Congrats on the good news.  The link below provides information on being poz and seeking entry into Canada.

http://www.aidslaw.ca/publications/interfaces/downloadFile.php?ref=1929

Joe

Offline Valmont

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Re: Some good news...
« Reply #5 on: January 12, 2012, 02:01:29 PM »
Hi Since...
Thanks for your words...

Yes, mi wife is negative, she has not been exposed for more than 6 months so the result can be conclusive...

In the case of Canada, Iīm the main applicant.  In a family, if one of the member donīt fullfill exigence, the application is denied for all the family member.  Also, health situation is checked one by one.  About the 2002-2004 guideline, I undestrand it is still actually used.  Canada is interested in that people that immigrate there wonīt cost them much more than the average Canadian.  Anyone with HAART wonīt be allower to have a permanent visa because of the treatment cost.  In my case, what has to be checked is that I should receive a treatment in a short term view in regard to Canadian Standards...


Hi Killfoile
Thanks for the link, it in the English version the second I put, much better for people here...


Iīve seen quickly my doc this morning, if my VL will be still the same in 6 months, we will probably start HAART; with a VL such so high as mine, Iīm not so sure that CD4 will stay so high for a long time...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline eric48

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Re: Some good news...
« Reply #6 on: January 12, 2012, 05:26:38 PM »
I donīt have % CD4, labs never do them because here "docs donīt use it"....

Technically speaking this is incorrect. For your education you may want to know htat there is no 'machine' that counts CD4... there are 'machines' that count lymphocytes, then a test that gives the CD4 %. From that % the CD4 count is then calculated.

You doc. may not give you that CD4 % but if your lab sheet shows the total lymphocyte count, then simply divide your CD4 count by the lymphocyte total count to get the %

Hope this helps

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

Offline newt

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Re: Some good news...
« Reply #7 on: January 12, 2012, 06:10:46 PM »
Quote
there is no 'machine' that counts CD4... there are 'machines' that count lymphocytes, then a test that gives the CD4 %. From that % the CD4 count is then calculated.

I believe it's the other way round, ie cells are counted in a sample then the % is calculated from the total lymphocytes count.

The CD lymphocyte test (ie CD4 test) analyses CD3+ cells, some of which are also marked CD4+ (helper cells that identify foreign bodies) and CD8+ (killer cells that have a go at foreign bodies, broadly speaking). So you should always be able to get an absolute CD4 and CD8 count, CD4 and CD8 % and CD4/CD8 ratio.

The + here refers to an glycoprotein (sugar/protein compound) on the surface of the cell which is used as a binder to foreign particles in the body like HIV.

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

Offline phost86

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Re: Some good news...
« Reply #8 on: January 12, 2012, 10:53:58 PM »
Good to hear it about the wife and son! You must have been so relieved:)

Offline Theyer

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Re: Some good news...
« Reply #9 on: January 13, 2012, 09:21:19 AM »
That's the way to start the new year,congrats.
What the heck is a "titular " My brother has a Box at Bath Rugby club and I like surprising him with info that he,d never think I,d have.
I am really very pleased and happy for you all.
All the best
mhtv
"If we can find the money to kill people, we can find the money to help people ."  Tony Benn

Offline Ann

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Re: Some good news...
« Reply #10 on: January 13, 2012, 09:37:51 AM »
Val, I'm so happy your wife finally got tested, and even happier that she is negative. And yes, it does mean your son is negative as well. Congratulations! I bet it's a load off your mind - I know it's a load off mine. :)

Your numbers are going to fluctuate - including your VL. You might be under the required 55,000 one test, and above it the next and you will have no way of controlling that or knowing which way it will be.

Unless you go on meds and become undetectable, that is. Under the circumstances, if I were you I'd probably go on meds so that my application for moving to Canada isn't rejected.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Joe K

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Re: Some good news...
« Reply #11 on: January 13, 2012, 10:16:38 AM »
Unless you go on meds and become undetectable, that is. Under the circumstances, if I were you I'd probably go on meds so that my application for moving to Canada isn't rejected.

Your best bet is to enter Canada without needing any HIV meds.  The following describes the current criteria for how they treat applicants who need HIV meds.

"If you are taking antiretroviral medications… Immigration medical officials have indicated that an applicant for permanent residence who is living with HIV and who is currently taking antiretroviral medication (whether or not s/he is in good health) is medically inadmissible.

This is because antiretroviral medications are expensive and are publicly funded to some degree for residents according to the rules of the province or territory where they live.  (The extent to which medication costs are covered by public insurance varies from jurisdiction to jurisdiction within Canada.)  For applicants with private medical coverage that covers the cost of antiretroviral medication, CIC has taken the view that because publicly funded health benefits are fully available to permanent residents, having private insurance does not guarantee that the applicant will continue to use private insurance. 

However, in December 2009 the Federal Court held in Companioni v. Canada (Minister of Citizenship and Immigration) that permanent residence applicants with HIV should have an opportunity to demonstrate their ability to bear the costs of their medication in order to avoid being determined medically inadmissible.
 
This will have particular significance for prospective immigrants who are HIV-positive and either living in Canada and employed in situations where their prescription medication is covered or have medical insurance plans that are transferable to Canada.

The Federal Court has also held, however, on numerous occasions that a  permanent residence applicant who promises to pay for medications “out-of-pocket” using savings or other means will generally still be found to be medically inadmissible.  This is because there is no way to enforce such a promise, and the law guarantees that all permanent residents have equal access to public health insurance."

source: http://www.aidslaw.ca/publications/interfaces/downloadFile.php?ref=1929

Val, hopefully your numbers will stay strong.  Have you looked into getting temporary insurance, before moving to Canada, as most provincial health plans have a waiting time for coverage?  It's usually an average of 90 days, AFTER you move. 

Joe
« Last Edit: January 13, 2012, 10:32:00 AM by killfoile »

Offline Valmont

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Re: Some good news...
« Reply #12 on: January 13, 2012, 02:05:47 PM »
Ok, many thanks for your answers...

I reply:

1- About CD4 %.  I asked my lab, which is a national public health lab why they did not put this, the responsable got angry and no very kind and answered they put what medicals need and that they know what they do. I insisted telling him that outside this information was considered, and I thought he was going to tell me to go outside.

My doc says that CD4 number permite to estimate CD4 %, mmmm  Iīm not so sure... 

I talked with a friend of mine, also doctor, that told me that guidelines in south america considered CD4 number and not CD4 %...

Anyway something is happening there...

Eric, if I estimate my CD% the way you explained, (CD4 714 and Linfocitos: 2,3)the result is 32,2 %.  Is that posible????


2- About Canada, thank you killfoile, that is right that if I was receiving HAART, my permanent visa would have been immediatly denied.  What they are watching is the cost one is going to generate in the next 5 or 10 years to their social system...  I have to be lower than the average canadian, and HAART is clearly expensive...

Calification is individual.  In the case of a familly, if one member donīt qualify, the visa is denied to all members.  What you can bring to CAnadian society is not considered (profesion and so on...)

About insurance and the case you explain, this is very interesting and maybe I can get an private insurance from France for those whom live outside (CFE), but during last 11 years I have never been able to do it because of its cost that are similar to those in France (my income is NOT), travelling in Canada can help me to generate a good income an pay it.  I also can contract it before...  Well, this will be plan "B" if the visa is denied and when I will insist for a decsion revision... 

3- About Rugby...  Today I play, tomorrow what?  People change here exactly they way the country does...  Nothing is never sure...

4- About my familly, for sure it is a great news and Iīm very happy.  But my wifeīs conduct have been quite strange last days, she made me comments that were really hurtly ("well, so I will have to care of you soon when youīll get bad", or "what a pity youīre going to die before me, I will be alone to grow up our son and he wonīt have a father", she also jokes with the possibility to have another children with another man, this does not bother me, what bother me is the way how she tells it...)  and she is still asking me for supporting her emotionnally.  I donīt know if I did well, but last months, any time I could, I minimized HIV effects and showed me as stronger as Iīm really am.  I can give her some more time, sure, mmm, we spent 8 terrific months that could have been much less if she would have done her test before...  Yes, I have a little bad feeling about this too, but I try to breath and be patient...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline newt

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Re: Some good news...
« Reply #13 on: January 13, 2012, 03:01:18 PM »
CD4% is total CD4 cells divided by total lymphocytes x 100. A "normal" range for CD4% is perhaps between 32% and 68%

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

Offline Valmont

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Re: Some good news...
« Reply #14 on: January 13, 2012, 05:13:52 PM »
Having 32 % sounds really really great for now !!!
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

Offline eric48

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Re: Some good news...
« Reply #15 on: January 13, 2012, 07:16:51 PM »
I believe it's the other way round

The explanation I gave is verbatim the one I got when I asked my biologist.

It is further explained here: (article dated 2011, not some older stuff...)

http://www.aidsetc.org/aidsetc?page=cg-206_cd4_monitoring
CD4 and Viral Load Monitoring

which states:
The CD4 percentage is the percentage of the lymphocyte population that is CD4+; it is measured directly by flow cytometry. .... The absolute CD4 count is calculated from the CD4 cell percentage and the total white blood cell (bold added by me for clarity)

This is the most common technique and the one my lab uses.

Apparently some flowcytometers manufacturers (Beckman) seem to have come up recently with flowcytometer that do a direct count, but they are not common for commercial labs.

It is easy to sort out which method your lab uses.

If you take a look at your lab sheet, take the total lymphocyte count and the CD4 count.
Divide the CD4 count by the total lymphocyte: that yield the percentage. If the result is always an integer (that is without any decimal point), then it proves that it is the percentage that has been used to calculate the CD4 count. On the contrary, if the result comes out with somewhat random decimal part, then it is most likely the other way around.

There are a few posters on this forum who report CD4% with a decimal fraction (accuracy)
most report with an integer. Which seems to indicate that the method described in the above article is the most widely used.

Should my rationale not be convincing, anyone is free to ask one's biologist.

Which is what I did...

Hope this helps

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

Offline eric48

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Re: Some good news...
« Reply #16 on: January 13, 2012, 07:47:15 PM »
A much detailed description is given here:
http://www.searo.who.int/LinkFiles/BCT_HLM-392.pdf

Methods of CD4 T lymphocytes count measurement : page 24

but says the same:
Relative percentages of the cells expressing the specific receptor (eg. CD4)
on its surface are obtained from the flow cytometer and the absolute counts
can be calculated with the help of absolute lymphocyte count

EOF

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

Offline Ann

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Re: Some good news...
« Reply #17 on: January 14, 2012, 06:11:26 AM »
Your best bet is to enter Canada without needing any HIV meds.  The following describes the current criteria for how they treat applicants who need HIV meds.


Ooops, thanks for putting that right, Joe.
Condoms are a girl's best friend

Condom and Lube Info  



"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline Valmont

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Re: Some good news...
« Reply #18 on: January 15, 2012, 11:45:55 PM »
Thanks for the info...

Well, here, I donīt know which type of material they use...

About my results sheet, well, they donīt put many things, only CD 4 number, and VL (with a quality test).

My lymphocytes total count is done in another lab, another day (it is completely impossible todo both the same day, hospital are not so close one from the other, but....  people arrive from 6:00 AM for the sample and it is better to bring a good big book !!!!)


In another way, in regard to Canada, Iīm about have a great plan "B" if my visa is denied for an high cost to system health because of HIV.  As a French people, I have access to French public insurance for those who live outside from France (CFE)...  It is particularly expensive (that is why Iīve never used it in 12 years outside), but less than buying meds without insurance and I understand they cannot exclude someone because of HIV...  Also it can allow me to get access to better medecines, more tests and so on than what Ecuador is offering (and it is not so bad...).  This should be an good answer to them....  Tomorrow Iīll call CFE and see...
Apr 2011: Diagnotized
Jun 2011: CD4: 504  VL: 176.000
Dic 2011: CD4: 714  VL: 95.000
May 2012: CD4: 395 VL: 67.000
Jun 2012: CD4: 367
Agu 2012: Starting Emtricitabine 200 mg / Tenofovir 300 mg and Efavirenz 600 mg (2 pills) different brands or VIRADAY/ATRIPLA/Mylan....
Sep 2012: VL: 138
Dic 2012: CD4: 708 VL: <34  %CD4: 32%
Jan 2013: CD4: 707 VL: <20
May 2013: CD4: 945 VL: <34 %CD4: 33%
Agu 2013: CD4: 636 VL: <34 %CD4: 50%
Dic 2013: Latent TB, started Isoniazid

 


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