Main Forums > I Just Tested Poz

Recently diagnosed, VL of 47 then 43, elite controller?

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leatherman:

--- Quote from: Souledout on October 30, 2012, 10:43:50 AM ---leatherman, I seem completely unable to find the private message reply button so can't get back to you :)

--- End quote ---
you have to have 3 regular posts before the PM system kicks in.
(oops! took too long writing this up and got beat to the punch. LOL)
You now have 3 posts. WooHoo! ;D

Oh I can understand worrying about numbers. It took me 12 yrs to reach undetectable (and at that time UD was still 400 I think) and 17 yrs of meds for my cd4s to hit 300. While I worried a lot getting from there to here, looking back now I can say the stress wasn't worth it. ;) Sometimes worrying about the numbers (especially when the change is insignificant) is useless and what you should be focusing on is the good health you have, the life you are living and enjoying, and general stress reduction.

But what I did point out in my PM and wanted to make as my point was that it's all about the trends over time. Right now your 47 to 43 is statistically no change at all - especially as it seems these tests may have been a month or less apart. To be a significant change you need to see your count go to 4 or to 400 as significant viral load change is defined as a logarithmic function

here's some info about the log value/change (in order of significance)
http://www.aids.org/topics/aids-factsheets/aids-background-information/what-is-aids/safer-sex-guidelines/viral-load-tests/
http://i-base.info/qa/factsheets/viral-load-converting-log-values-to-numbers
http://www.thebody.com/content/art12795.html

oh, and since you're new to this stuff, don't let me forget to point out the excellent LESSONS section here (2nd column under the TREATMENT button in the menubar)  ;)

friskyguy:
pls think carefully about going on meds right away. With more acceptable meds now with less side effects, guidelines in the US now recommend commencement of meds regardless of viral load. I recall more progressive cities in the US, ie San Franscisco and New York have had some good results with earlier commencement of meds.

Guidelines in the UK are not as aggressive but there seems to be a genuine movement to earlier commencement regardless. I reckon the brits will move in line with the US soon enough. Maybe the increased costs of such a move could be part of their current decision as there is universal coverage there and very expensive if they lower the threshold/change guidelines.

I believe the recent current thinking is that an earlier commencement of meds would assist in smaller viral reservoirs and therefore well placed for a cure if and when a treatment at reducing the viral reservoir is in place. Also ealier commencement of meds would assist in reducing inflamation in your body and therefore reduce those nasty complications caused my constant low levels of virus.

Also remember HIV is now populating your CNS which is bad news. Also meds would assist in preservation of your immune system and building on your good numbers today and assist in protecting your CNS.

Everyone gets hung up on viral load which yes it is very important but as new studies come to light remember viral load is only just part of the story of HIV monitoring and prevention of complications.

All good reasons to start now but of course you need to discuss with an 'up to date' doctor with real experience with elite controllers to make an informed decision for yourself.

Souledout:
Thanks. I'm pretty clued up on the log system, I studied chemistry at university so got a reasonable mathematical/scientific head on my shoulders (which is pretty useful when it comes to understanding complicated research papers). Even though I know a drop of 4 isn't really significant it would be a little morale boosting victory, and it would be even better to keep it there for some time.

Souledout:
At the moment im really not keen on medication. I'm aware that there is some evidence that going on meds early is beneficial but most of the evidence will have been gathered from people wit far higher viral loads than me. I know that keeping my body fighting the virus on its own does cause inflammation over time and maybe I will decide its best for me to go on meds early but that's something I have to discuss at length. Choosing a lifelong regime of medication is not a decision to be taken lightly. Again, I'll know more about my status in a few weeks and then over the next few months, at which point I can make a more informed choice.
I guess I've got to read a few more papers on the subject.

Jmarksto:
Souledout;

Deciding when to start meds is such a personal choice - given your numbers, the "newness", etc. I think you are wise to take your time with that decision, but also to keep a close eye on it.

My doc, who specializes in HIV, wanted me to wait 3 - 6 months for me to adjust emotionally, get educated, and make sure that I would be consistent with my meds.  I was much more freaked out than you are (by the sounds of it anyway) and he knew it.  I did want to start earlier, primarily to reduce the risk of transmission to my partner.  I did notice that I have more energy and my minor skin rashes went away after starting meds.

You noted that you don't know anyone else who is positive -- which I didn't either.  My doctor recommended a therapist that specializes in HIV - which has been a great help.  Others have noted support groups that have been helpful. 

Again, welcome and I wish you well,

JM

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