Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Logic of CD4 versus VL numbers.

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Irish Eyes:
I'm trying to absorb everything here and though I understand the reasons that starting meds are to increase CD4 numbers and decrease VL (viral load) numbers.

I think my questions are,
Are the meds designed work solely to increase CD4 (white blood cells), which in turn automatically reduces the VL, with the goal of reducing VL to UD (undetectable).

And is reason to reach UD level, solely to lessen possibility of transmission of virus, or is it also for carriers wellbeing as body is not fighting virus at UD levels

Does that make sense, or am I missing something?

FYI. I'm not a dingbat, I do read (books), write in cursive and can tie my own shoelaces.



zach:

--- Quote from: Irish Eyes on March 03, 2014, 02:42:02 AM ---
I think my questions are,
Are the meds designed work solely to increase CD4 (white blood cells), which in turn automatically reduces the VL, with the goal of reducing VL to UD (undetectable).

And is reason to reach UD level, solely to lessen possibility of transmission of virus, or is it also for carriers wellbeing as body is not fighting virus at UD levels


--- End quote ---

completely opposite, meds reduce viral load. you want that. they do this by preventing the virus from replicating. as VL goes down, your cd4 is able to rebuild as a byproduct.

transmission risk is not the sole reason to aim for UD, but it does lessen the risk. don't take that risk though. your health in general will improve and benefit from UD viral load. your immune system will rebuild, and you system will be able to maintain better health and fight off the environmental nasty stuff we all encounter.

you can write in cursive?!?! seriously, i look illiterate even signing my name.

Irish Eyes:
Thanks Z.
Understood.
Perhaps I am a dingbat after all.

leatherman:

--- Quote from: Irish Eyes on March 03, 2014, 02:42:02 AM ---I understand the reasons that starting meds are to increase CD4 numbers

--- End quote ---
actually, there is no real way to increase cd4s. There are some meds (mostly in testing still) with limited results, and there are some actions (exercise, eating well, etc) that can help; but cd4 count is mainly a matter of genetics. That's why there is such a large range for "normal" (500-1500). there is no magic number to reach. matter-of-fact unless you had a cd4 count BEFORE you tested poz (and I've never met a person yet who had done that) you don't even know what your "normal" level of immune system cd4s (and cd8s) you had, so there is no way to know what level you should even be hoping to reach. ::)

then there are the issues of cd4s themselves. They can change by up to 100 pts in a day!! So yes, 400 can basically be equal to 500. The only way to get a read on realistic number you could use, would be to use the trend of (and not the average of) at least 3 tests over a certain amt of time (say at least 3 months).

see the chart in my sig line? I could tell you that my average cd4 count of 22 yrs or so of meds is a measly 157. But as you can see from 2004 when I finally got a good therapy I could tolerate (reyataz/norvir/truvada), the average doesn't even begin to explain the rise and leveling off that my cd4s have done through the years. It doesn't explain about 16 yrs without any other OIs or general illnesses. It doesn't even show how I blipped up to 407 (which thrilled my doc much more than it should have LOL) and then back now to 315 (which I bet the doc I'd go back to by the next test. I won the bet!)

and finally, with cd4s, it has nothing to do with how many you have (well, not as long as you generally have over 200 since that seems to be the "magical" number after which OIs can get a foot hold). If you only have 250-300 (like I do) and can say you haven't been back in the hospital in nearly 2 decades or even hardly sick in all those yrs (maybe a cold or two), then your immune system must be doing pretty dang well. On the other hand, check out some of the stories here. There are people well over 500, 700, and even 1000 who are having health problem after health problem. so in this way, you should see that the cd4 count doesn't even accurately reflect of how "well"/"healthy"/"not sick" a person is.

so the trick to successful ART is to reduce the viral load, which reduces the destruction to the immune system, so that the body can recover to a higher cd4 level and be less prone to opportunistic infections. The nice bonus win (besides not being "sick" with AIDS) to reducing the VL is that it makes an HIV+ person 94-96% less likely to transmit HIV. So it's a win (healthy pozzie person) - win (decreased HIV transmission ie fewer HIV diagnoses) for everyone.

RapidRod:
Irish, to put it in layman's terms the ARVs are used to slow down and stop the virus from replicating. Your VL results are the guide to your physician of your HIV progression as to how well your medication is or is not working.

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