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Author Topic: Viral load UD but CD4 going down and getting slimmer. Is that all right?  (Read 2103 times)

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Offline Pek

  • Member
  • Posts: 23
Hi,
1 month ago I got my lab tests and got a little bit worried because my CD4 went close to the level when I find out about my status. My doctor said that as long as the viral load is UD everything is all right. It made me feel better but I am still worried.

My lab tests

jul 2012  hiv poz / VL 9,900 / CD4 284

3 aug 2012 started truvada and viramune

20 aug 2012 VL UD / CD4 336

oct 2012 VL UD / CD4 411

dec 2012 VL UD / CD4 480

Jan 2013 VL UD / CD4 414

May 2013 VL UD / CD4 344

Aug 2013 VL UD / CD4 306

There is another thing  I am worried that since I know I am poz I am loosing weight although I do not think I have changed my eating habits(but maybe a little bit). When I went to the clinic last time I said it to the doctor and I asked to check about my weight history since I go there. She said that in Aug 2012 I had 78kg and now 1 year later I have 71,5 kg and I was loosing it gradually. She said that she would check my thyroid but she does not think it is related to the hiv.

Is that all right?

Is there anything I can do to bring up my CD4 apart from taking meds?

Any other advice?

Many thanks





« Last Edit: September 13, 2013, 02:35:33 AM by Pek »

Offline ad2san

  • Member
  • Posts: 189
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #1 on: September 13, 2013, 02:41:19 AM »
Hi Pek,

it is difficult to say ... some people loose weight some gain (me  :-[ ) ... It may or may not be related to the med and/or HIV .... hard to say. Why don't you start training to get some good heavy muscles  :o

Concerning CD4 give it some time ... you're UD and that is the primary goal. If you can (resistance, availability in the country your are in)  ask your doc if changing therapy could help a CD4 rebound ....

Cheers
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%
Aug 2014 CD4 639 UD 25%

Offline weasel

  • Member
  • Posts: 1,686
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #2 on: September 13, 2013, 06:45:18 AM »


   Hi Pek  ,
                   Nice to meet you  :)

    Being UD is good ,   I've had HIV for years , At times my My CD-4's have been very good over 1,000 .  Now a days they are around 300 ?    Last year 565 was my highest !
  I don't worry to much about the number anymore , Different times of the day that number will change  ;)

    As for loosing weight you say you changed your eating habits a little .I stopped putting cream and sugar in my coffee and lost ten pounds in a year  ;D   It is little changes that do the trick !   
 Having more muscle mass will require eating more foods to keep the weight on . I see no issue with thin myself .   I feel more perky and fluffy when I get down to around 200 pounds .

                                             Be well ,
                                                               Weasel   
" Live and let Live "

Offline eric48

  • Member
  • Posts: 1,190
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #3 on: September 13, 2013, 05:46:12 PM »
When on meds, forget about the count, it is the Percentage that ... counts LOL

Have a look at your %

They should be OK

Cheers

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

Offline Pek

  • Member
  • Posts: 23
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #4 on: September 14, 2013, 05:38:50 PM »
Hi Pek,

it is difficult to say ... some people loose weight some gain (me  :-[ ) ... It may or may not be related to the med and/or HIV .... hard to say. Why don't you start training to get some good heavy muscles  :o

Concerning CD4 give it some time ... you're UD and that is the primary goal. If you can (resistance, availability in the country your are in)  ask your doc if changing therapy could help a CD4 rebound ....

Cheers


I am trying to go to the gym but it has not been easy to change so many things in my life in 1 year.

is there combinations that are better to increase the CD4?

thanks

Offline Pek

  • Member
  • Posts: 23
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #5 on: September 14, 2013, 05:40:37 PM »

   Hi Pek  ,
                   Nice to meet you  :)

    Being UD is good ,   I've had HIV for years , At times my My CD-4's have been very good over 1,000 .  Now a days they are around 300 ?    Last year 565 was my highest !
  I don't worry to much about the number anymore , Different times of the day that number will change  ;)

    As for loosing weight you say you changed your eating habits a little .I stopped putting cream and sugar in my coffee and lost ten pounds in a year  ;D   It is little changes that do the trick !   
 Having more muscle mass will require eating more foods to keep the weight on . I see no issue with thin myself .   I feel more perky and fluffy when I get down to around 200 pounds .

                                             Be well ,
                                                               Weasel
Nice to meet u too...

I do like my body now... I was just worried if it was related to the HIV or meds...

thanks

Offline Pek

  • Member
  • Posts: 23
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #6 on: September 14, 2013, 05:42:04 PM »
When on meds, forget about the count, it is the Percentage that ... counts LOL

Have a look at your %

They should be OK

Cheers

Eric

We do not get the lab test in my country, they just say the results and they never told me about the %.. I will ask next time I go the clinic

Thanks

Offline ad2san

  • Member
  • Posts: 189
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #7 on: September 15, 2013, 05:21:16 AM »

is there combinations that are better to increase the CD4?

thanks

you need to discuss with with your doc .... I am sure that he/she will give you the best therapy combination adapted to your case. Depending in the country you're living in some combination may or may not be available ... your doc knows.

Cheers
Feb   2009 CD4 358 VL 2000 16%
May  2009 CD4 305 VL 3069  14% <---- Started TVD+ATZ/r
Jul  2009 CD4 512 VL <50   18%
Jul 2010 CD4 418 VL <50 24%                     
Switched to Kivexa (Epzicom) + Norvir + Reyataz (due to sleep problem)
Aug 2010 CD4 606 VL <50 25%
Jul 2011 CD4 494 UD 23%
Switched to Kivexa (Epzicom) + Viramune XR (due to kidney problems)
January 2012 CD4 564 UD 31%
October 2012 CD4 684 UD 29%
January 2013 CD4 594 UD 26%
Switched to Kivexa (Epzicom) + Isentress due to BIG increase GammaGT
Feb 2013 CD4 699 UD 28%
May 2013 CD4 385 UD 28%
July 2013 CD4 CD4 636 UD 25%
Oct 2013 CD4 588 UD 39%
Aug 2014 CD4 639 UD 25%

Offline eric48

  • Member
  • Posts: 1,190
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #8 on: September 15, 2013, 05:01:17 PM »
is there combinations that are better to increase the CD4?

compared with older drugs or to the times where few drugs were available, modern drugs are good at suppressing the virus in almost 95%+ of patients.

When not on meds the CD4 dynamics are governed (aka daewinian pressure) by cell self-death (apotosis, suicide, ...) (mainly) and CD8 control (to a significant extend)

If virus replication is fully achieved (usually refered to as being UD), the self death rate is down to almost zero and the CD4 dynamics are solely under control of immune response. The immune systems regains control.

There are some marginal benefits in CD4 gains with some combos, for exemple PIs will lead a a faster VL decay, hence faster CD4 initial gain. RAL also seem to have this effect.

Yet, this is only at begining of treatment and Doc may prefer PI containing combos for patients that have a very low nadir CD4.

This is not your case , since you have never been immuno depressed

On the longer run (say after a few month) this initial advantage (and only in limited cases) fades and, no, there is no combo leading to (long term) better CD4 recovery than an other. Even adding one more drig will not help. This is because once the replication is succesfully suppressed (and if it is) then, the immune system and its intrinsic dynamics govern the CD4 gain.

(if there was, you can be sure the drug company that holds the right to that drug will make a lot of advertizing about it. Yest, you will never see such claims)

The one thing that does help is : time

Give it time

Also, for past and future results, you should always retrieve the following data

VL ; CD4 count AND %; CD8 count AND %;

you need to keep track of the entire picture through out your history. In case you move, change clinic or whatever, having these data at hand will help you next doctor

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 Pek

  • Member
  • Posts: 23
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #9 on: September 19, 2013, 10:25:37 PM »
Thanks everyone who has replied.

Eric I did appreciate your well explained post. It did help me. Although today I read a news about hiv poz who had not achieved  the CD4 of 500 mark has less expectancy  of live than hiv neg people.

http://www.thebodypro.com/content/72593/undetectable-is-not-always-enough-immunologic-nonr.html

I remember that the doctor who prescribed me my combo said that usually there is a 3 year period that we get a good CD4 increase after that it changes just a little bit. Anyone has heard about it?

Many thanks

Offline Jeff G

  • Administrator
  • Member
  • Posts: 12,158
  • How am I doing Beren ?
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #10 on: September 19, 2013, 10:43:31 PM »
It took me over 10 years to see cd4 counts in the 450 range and I have been poz for over 30 years , so give it time .

Offline eric48

  • Member
  • Posts: 1,190
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: Viral load UD but CD4 going down and getting slimmer. Is that all right?
« Reply #11 on: September 20, 2013, 01:32:31 AM »
Hi,

Okay, here is something that you add to your combo and will work and is covered by inssurance...

give it TIME ;-)

Eric
(note: a non responder is some one whose CD4 is <200 OR CD4 COUNT increase is less than 5%, this, after 3 years of therapy)

next week or week after I'll post a very interesting graph here
tinyurl.com/HIVPharmaCure-12
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 3 months (2013: FOTO= 5d. ON 2d. OFF)

 


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