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Author Topic: Newly diagnosed and no sense of urgency from dr.  (Read 18090 times)

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Offline buginme2

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  • Posts: 3,426
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #100 on: December 28, 2014, 10:48:51 AM »
Are you sure your hearing your doctor correctly?

The reason I ask is because according to your signature line you spent a long period of time detectable with low level of viremia.  It's not until your most recent test that you became undetectable. 

It would make more sense if your doctor was considering changing your meds if this test hadn't returned undetectable.  Over the past year you've been hovering in the 100 range.   It's just in the last test your<20. 
Don't be fancy, just get dancey

Offline zach

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #101 on: December 28, 2014, 11:08:44 AM »
Oh and Zach. Watz up with the derogatory name calling. If anything it should be flat ass.
I'm down from 32" waist to a flattering 29"

The last time I bought size 29 was for school uniform about an eon ago.

i was just messin with ya man, i'm sure you're looking great... and i want pics of that school uniform

tequila body shots on me
An honest tune with a lingering lead has taken me this far

Offline absopozilutely

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #102 on: December 28, 2014, 05:19:41 PM »
i was just messin with ya man, i'm sure you're looking great... and i want pics of that school uniform

tequila body shots on me
Lol I'm on the phone reading this all to Irish. I just got my test results at UD <48 and 47% CD4 at 799 if I recall correctly, I know 47%. Anyways, I just wanted to steal Irisheyes Thunder. Also, Zach can we do the body shots on you? Jeff and Me can really get a party going.
12/18 Infected
2/4 12:22pm tested POZ via ORAquick
2/19 WB Confirmation
2/4-2/19 VL 104,678 CD4 407
3/2 Genotype back, and Started Complera
4/2-CD4 688 38% and VL 1,600
5/1-CD4 592 42% and VL 336
5/22-CD4 732 31% and VL 109 :( STILL NOT UD!
5/31 Switched to Stribild :( I'll miss you Complera!
6/19 CD4 508 35% and VL UD!!!!! Crying at work like a baby.
9/19 CD4 799 46% VL UD yayyyy

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #103 on: December 28, 2014, 07:48:40 PM »
and 47%
of course, the cd4/cd8 percentage is really most useful when someone is contemplating whether to start meds at the 350 mark and wants a little more info about how much damage has happened to their immune system. The percentage (which averages between 30-60%) can show whether someone might experience IRIS (immune reconstitution inflammatory syndrome - when you've actually gotten well enough to be sick LOL) after starting meds. (http://www.aidsmap.com/CD4CD8-ratio/page/1733224/ and http://www.aidsinfonet.org/fact_sheets/view/124)

In 31 yrs of being poz, I've asked about my percentage twice LOL and it never gave me any useful information. Actually what it did show me was that my 300 cd4s do a bang up job as my percentage at 16-18% is still just barely above the AIDS-range (14% and below)
leatherman (aka mIkIE)

So we put our hands up like the ceiling canít hold us
"Can't Hold Us" - Macklemore & Ryan Lewis

chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Irish Eyes

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #104 on: December 28, 2014, 08:24:28 PM »

.......is this an infectious disease/HIV doctor or general practitioner? That explanation she gave, in all honesty, is stupid and totally incompatible with current HIV treatment guidelines. Quite frankly, you are paying for bad medical advice if your doctor doesn't understand what <20 means. Maybe your doctor doesn't know enough about HIV to understand.......


She is an ID doc in the HIV department of UCSD medical center.


Are you sure your hearing your doctor correctly?

The reason I ask is because according to your signature line you spent a long period of time detectable with low level of viremia.  It's not until your most recent test that you became undetectable. 

It would make more sense if your doctor was considering changing your meds if this test hadn't returned undetectable.  Over the past year you've been hovering in the 100 range.   It's just in the last test your<20. 


My next draw is at end of Jan and depending on results on 2/9 appointment, then she anticipates change of meds.
She believes there may be resistance issues with a component in Stribild.
Till then I shall be trying to increase calories to assist absorption.


i was just messin with ya man, i'm sure you're looking great... and i want pics of that school uniform


I know you were messin.
As for photos..... they're few and far between, even The Latin is still waiting for one.
10/30/13          Exposure
Mid-Nov-Jan    Seroconversion (7-8 rough wks)
12.26.2013      WB dx. HIV+
02.01.2014      OraQuick (result Negative?)
01.31.2014      VL 250700
02.03.2014      CD4  491  26%
02.26.2014      CD4  503  26%
03.05.2014      HLA B6701  not present
03.18.2014      VL 530873 (typical fluctuation)
03.21.2014      Start Stribild
04.14.2014      VL 104 after 24 doses
05.12.2014      VL 129 after 52 doses
06.10.2014      CD4 940 32%
06.11.2014      VL 87
07.22.2014      VL 20
09.23.2014      VL 43
11.26.2014      CD4 1350 33%
01.26.2015.     VL 27
11.26.2014      VL <20

Offline leatherman

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  • Google and HIV meds are Your Friends
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #105 on: December 28, 2014, 08:36:05 PM »
She believes there may be resistance issues with a component in Stribild.
a rising viral load is a sign of resistance. An Undetectable viral load (and <20 IS undetectable) is NOT a sign of resistance. <20 cannot even be considered a "blip" if you had had a result of "O" for 20 yrs. Your doctor is very foolish to even suggest a med change for such a negligible blood result. :(
leatherman (aka mIkIE)

So we put our hands up like the ceiling canít hold us
"Can't Hold Us" - Macklemore & Ryan Lewis

chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Wonderbread

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  • Posts: 10
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #106 on: December 29, 2014, 08:02:33 PM »
a rising viral load is a sign of resistance. An Undetectable viral load (and <20 IS undetectable) is NOT a sign of resistance. <20 cannot even be considered a "blip" if you had had a result of "O" for 20 yrs. Your doctor is very foolish to even suggest a med change for such a negligible blood result. :(

Ditto to just about everything Leatherman said on this thread.

I'm wondering if the ID is using something like the ultrasensitive PCR my doc used in 1999-2000 (part of an observational study, if my aging memory is worth anything). It would quantify down to 26 copies, report a qualitative result ("detected") between 13-25, and finally "undetectable" below that.

Regardless, it seems fairly absurd to contemplate changing meds absent virological failure/tolerability issues/dosing inconvenience. Below 20 copies obviously isn't a failure. So that leaves what?

Irish, if you're not comfortable with the idea of switching based on your experience & labwork thus far, don't hesitate to push back. That can be a critical tool in managing your care. This is your decision, not your doc's.

Offline leatherman

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #107 on: December 29, 2014, 10:33:32 PM »
Ditto to just about everything Leatherman said on this thread.
"just about everything"??  >:( :P  Hmph! LOL  :D
welcome to the forums, Wonder! Don't forget to start a thread and intro yourself
leatherman (aka mIkIE)

So we put our hands up like the ceiling canít hold us
"Can't Hold Us" - Macklemore & Ryan Lewis

chart from 1992-2013; updated 2/09/13  Reyataz/Norvir/Truvada

Offline Wonderbread

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  • Posts: 10
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #108 on: December 30, 2014, 03:11:42 PM »
"just about everything"??  >:( :P  Hmph! LOL  :D

:P Nobody's perfect.

I had just skimmed through this thread and saw a discussion from June where I think you answered the wrong question... it was so long ago, I wasn't motivated to comment:

that percentage (for what little it matters) is the ratio of cd4 cells and cd8 cells. You simply have a higher ratio.

Abso was questioning why radically different CD4 (helper) cell counts yielded similar percentages.

These percentages describe what proportion of all of the lymphocytes (a type of white blood cell) circulating in your blood express the CD4 structure. So if you have roughly 1500 total lymphocytes, of which 500 are CD4+, you'll have a CD4 percentage of 33 (or 500 / 1500 = 33%). But you could also have 900 CD4+ cells out of 2700 total lymphocytes and still have the same percentage (or 900 / 2700 = 33%). That was the answer to Abso's long forgotten question.

The info you quoted/linked to describes the ratio between the CD4 (helper) and CD8 (killer) T cells. You calculate this number by dividing the CD4 cell count by the CD8 cell count. Neither Abso nor Irish mentioned those ratios. They rarely come up in clinical management.

More about measuring CD4 cells: http://www.aidsmap.com/Why-CD4-counts-are-measured/page/1729267/


Offline zach

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  • Posts: 2,636
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #109 on: December 30, 2014, 03:40:24 PM »
wonderbread, you're gonna love eric  ::)
An honest tune with a lingering lead has taken me this far

Offline Jeff G

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  • Posts: 14,671
  • How am I doing Beren ?
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #110 on: December 30, 2014, 03:52:41 PM »
wonderbread, you're gonna love eric  ::)

LOL . Im only human so just LOL

Offline Irish Eyes

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  • A closed mind is a beautiful thing to lose
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #111 on: March 23, 2015, 06:01:55 AM »
So i had the ultra sensetive resistance test done and results showed zero resistance to any of the conponents in Stribild but the doc still wanted me to try Triumeq for a couple of months to see if my VL result would read UD as opposed to <20.
I agreed, mainly to satisfy her curosity. Though I was definately going to switch back to Stribild no matter the results from Triumeq.

As it turns Anthem no longer covers HIV meds, as of the start of 2015, and to get Triumeq it was going to be convoluted, so I decided to stick with refill of Stribild, which Anthem approved (for 1 more year of refills)as I was having good results with it and I had only 4 days of meds left.

So, long story short. I'm still on Stribild and life is good in the bottom left corner of the USA
10/30/13          Exposure
Mid-Nov-Jan    Seroconversion (7-8 rough wks)
12.26.2013      WB dx. HIV+
02.01.2014      OraQuick (result Negative?)
01.31.2014      VL 250700
02.03.2014      CD4  491  26%
02.26.2014      CD4  503  26%
03.05.2014      HLA B6701  not present
03.18.2014      VL 530873 (typical fluctuation)
03.21.2014      Start Stribild
04.14.2014      VL 104 after 24 doses
05.12.2014      VL 129 after 52 doses
06.10.2014      CD4 940 32%
06.11.2014      VL 87
07.22.2014      VL 20
09.23.2014      VL 43
11.26.2014      CD4 1350 33%
01.26.2015.     VL 27
11.26.2014      VL <20

Offline Miss Philicia

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #112 on: March 23, 2015, 10:43:07 AM »
<20 = undetectable

I don't understand you doctor's reasoning.
"Iíve slept with enough men to know that Iím not gay"

Offline AusShep

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  • Posts: 333
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #113 on: March 23, 2015, 02:22:15 PM »
<20 = undetectable

I don't understand you doctor's reasoning.

Ditto.  It means the virus was below the testing threshhold of 20 copies per ml, hence undetectable.

BTW, my husband had viral load test along with antibodies, etc. when he was considering going on PrEP and he gets the same <20 results as me on the RNA testing and he's negative. 

Offline absopozilutely

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Re: Newly diagnosed and no sense of urgency from dr.
« Reply #114 on: March 23, 2015, 11:35:41 PM »
To clarify its his pharmacist pushing the issue not the doctor, she needs to call IT, not change his regimen.
12/18 Infected
2/4 12:22pm tested POZ via ORAquick
2/19 WB Confirmation
2/4-2/19 VL 104,678 CD4 407
3/2 Genotype back, and Started Complera
4/2-CD4 688 38% and VL 1,600
5/1-CD4 592 42% and VL 336
5/22-CD4 732 31% and VL 109 :( STILL NOT UD!
5/31 Switched to Stribild :( I'll miss you Complera!
6/19 CD4 508 35% and VL UD!!!!! Crying at work like a baby.
9/19 CD4 799 46% VL UD yayyyy

Offline vertigo

  • Member
  • Posts: 189
Re: Newly diagnosed and no sense of urgency from dr.
« Reply #115 on: March 26, 2015, 01:17:16 AM »
With no resistance and a VL<20 you don't need a med change.  You may need a new doctor or pharmacist, however.  VL<20 is UD -- it's below the detectable limits of the viral assay.  So this line of inquiry is frankly very strange.  Are you sure your doc isn't a quack?  There are incompetents in every profession, medicine included.

 


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