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Author Topic: How Low are CD4's When Problems Start  (Read 4783 times)

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Offline David_CA

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  • Joined: March 2006
How Low are CD4's When Problems Start
« on: June 12, 2006, 09:03:38 AM »
Hi guys/gals,

This is something that's got me confused.  I have a problem with Seborrheic Dermatitis.  I've had this for about a year and a half... long before I knew I was HIV+.  I thought it was just dry skin.  From what I've read, only 3-5% of the general (HIV-) population have this while 85% of people with HIV are effected by it.  Would this be considered an OI?  It seems odd, with my CD4's being so high (462) that I'd be having problems like this.  My prior test showed my CD4's to be at 359.  I guess my question is at what point does one start having problems due to HIV?  I know my viral load has increased a bit from my previous test, but I know that goes up and down.  I realize this isn't really a major problem and should be easily taken care of, but it's got me wondering nevertheless.  Thanks for any ideas.

David
« Last Edit: June 12, 2006, 10:09:37 AM by David_NC »
Black Friday 03-03-2006
03-23-06 CD4 359 @27.4% VL 75,938
06-01-06 CD4 462 @24.3% VL > 100,000
08-15-06 CD4 388 @22.8% VL >  "
10-21-06 CD4 285 @21.9% VL >  "
  Atripla started 12-01-2006
01-08-07 CD4 429 @26.8% VL 1872!
05-08-07 CD4 478 @28.1% VL 740
08-03-07 CD4 509 @31.8% VL 370
11-06-07 CD4 570 @30.0% VL 140
02-21-08 CD4 648 @32.4% VL 600
05-19-08 CD4 695 @33.1% VL < 48 undetectable!
08-21-08 CD4 725 @34.5%
11-11-08 CD4 672 @39.5%
02-11-09 CD4 773 @36.8%
05-11-09 CD4 615 @36.2%
08-19-09 CD4 770 @38.5%
11-19-09 CD4 944 @33.7%
02-17-10 CD4 678 @39.9%  
06-03-10 CD4 768 @34.9%
09-21-10 CD4 685 @40.3%
01-10-11 CD4 908 @36.3%
05-23-11 CD4 846 @36.8% VL 80
02-13-12 CD4 911 @41.4% VL<20
You must be the change you want to see in the world.  Mahatma Gandhi

Offline Moffie65

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  • Posts: 1,755
  • Living POZ since 1983
Re: How low for CD4's and How high for VL
« Reply #1 on: June 12, 2006, 09:45:32 AM »
Gee David,

You do bring up the fun stuff don't you? 

The answer is YES!  I started to suffer from Folliculitis almost as soon as diagnosis.  Then I just thought it was terribly annoying, and ran around with pimples all over my body for years.  The condition seems to worsen in the summer when your pores are moist from sweat, but still it is with me most of the time.  I dealt with it using Physohex, which used to be available over the counter, but is now a doctors script only.  There is also another cleansing agent that is used pre-op in the hospital, which you might discuss with your doctor.  I have now started using both with regularity since summer has set in.  I have no idea if what you have named here is in any way related, but you might discuss it with your doctor anyway, to see if you can make an impact on it. 

As far as the CD4 relative numbers; it seems to me that there is little difference with symptoms, as I have had it plague me for the better part of 22 years.  I personally think that the virus affects the skin at any CD population, but I cannot back that up with any scientific proof, just observation and discussion with other HIV+'s that have an inordinate amount of body hair. 

I sure hope this helps, and if not, oh well, just more stuff to file away.

IN LOVE.
The Bible contains 6 admonishments to homosexuals,
and 362 to heterosexuals.
This doesn't mean that God doesn't love heterosexuals,
It's just that they need more supervision.
Lynn Lavne

Offline ademas

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Re: How Low are CD4's When Problems Start
« Reply #2 on: June 12, 2006, 09:51:11 AM »
Hi David,

Is seborrheic dermatitis considered an autoimmune disease?

I have trouble with psoriasis and psoriatic arthritis.  My skin isn't involved so much...just a couple of very small patches...but it's wreaked havoc on my feet and achilles tendons.  Because it's an autoimmune disorder, my doctor actually thinks the problem will tend to persist and worsen as my immune system stays stable (or continues to rebound), and since most breakthrough treatments for psoriatic arthritis involve suppression of the immune system...well, it's just not an option.

So...if it is considered an autoimmune disorder...it might just be rearing it's ugly head because your immune system is doing better.

xox



Offline carousel

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Re: How Low are CD4's When Problems Start
« Reply #3 on: June 12, 2006, 09:59:37 AM »
.
« Last Edit: February 15, 2007, 12:55:01 PM by carousel »

Offline Robert

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Re: How Low are CD4's When Problems Start
« Reply #4 on: June 12, 2006, 10:19:55 AM »
HI David.

We know HIV  weakens the body's ability to fight disease. Infections which are rarely seen in those with with normal immune systems are common to those with HIV.

I know when I think of Opportunity infections I think of AIDS, when your CD4 count drops below 200 and you become sick with PCP, AIDS Dementia Complex (ADC)
Peripheral Neuropathy , Kaposi's Sarcoma
Non-Hodgkin's Lymphoma, Progressive Multifocal Leukoencephalopathy (PML) (Which is what Jeff and Ron have). 

But there are certainly a number of other illnesses associated with HIV including bacterial infections and fungal infections (I have a toe nail fungus I just can't get rid of) and, of course, depression.  I think all of  these are OI's and, I suppose, can be treated but they're a bear to prevent because of our lower immune systems, they just seem ever-present. 

So yeah, I think your problem is HIV-related and even when you start meds, it won't necessarily go away.

robert

 
..........

Offline randym431

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  • Posts: 1,125
Re: How Low are CD4's When Problems Start
« Reply #5 on: June 12, 2006, 11:32:22 AM »
Hey David
I take it you have not started any meds yet. I wont ask why, but myself I'd get on something with that vl taking its toll on the old system. Even though your cd4's are above 200, your walking a tight rope. A doctor once told me the immune system attacked by hiv is like a piano keyboard (you probable heard this before?). The hiv might be taking out the C's and D's on the keyboard, even though your over all is in tacked. Putting down the vl to undetectable thru meds will save you from missing any further "keys" (if you will).
I don’t know, its a whole different theory or take on the virus for me, to continue to let it do its damage till you are near the point you fall off the tight rope. I never knew I was pos till I already had fallen off the tight rope. If I'd known I had this virus in my blood, I would have wanted to do whatever was needed to suppress it, regardless of the figures.
Watching the figures change, and slowly or rapidly change, for the worse seems a Russian roulette game from where I stand. But I know many doctors tell their people to wait to start meds, while watching the figures. I guess thats very foreign to me. To like "play" with the virus. Its out to do one thing, and that is win the battle.
Sorry for the long ramble here, but anything attacking the immune system (like hiv does) is still a mystery, as to what is actually happening and what ol's are taking a foot hold even though the figures are still looking fairly good.
I know the "meds" are a whole diff story, and can lead to problems in of their own (side effects). But what I fear is the virus more than the meds, and myself I wish I'd known much sooner and started meds right away. Come what may.
So to your question, who really knows what damage is being done, even with high cd4 counts. Its hard to draw a line.
Take care.
« Last Edit: June 12, 2006, 11:35:44 AM by randym431 »

Offline penguin

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  • The Penguin Whisperer
Re: How Low are CD4's When Problems Start
« Reply #6 on: June 12, 2006, 11:45:33 AM »
hey david...
it's actually very common in people with hiv, because we've got the whole compromised immune system thing going on... I get it in winter, when the weather gets really cold and my eczema gets bad, and b) when i get stressed/run down.
interesting fact...they think its probably caused by a fungus, possibly a species of Pityrosporum  :)

 few tips to deal with it...
hydrocortisone cream/lotion can be rubbed into the scalp or other areas until it calms down, this also helps it stop itching. be a bit careful with anything steroidal near the face though, it can thin the skin over a period of time.
Coal tar shampoos (neutrogena make one called T-gel, smells foul but works)
Anti-fungal creams from your dr can help, and if it gets really bad, a short course of fluconazole (an anti-fungal drug) should help clear it up.
I also make sure i eat plenty of oily fish/other sources of "good" fats, take a high quality zinc/fish oil/vitamin e supplement...and this may sound crazy, but new zealand manuka oil and UMF honey(the highest strength you can get hold of) really help too.

hope it's better soon...
kate

Offline whizzer

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  • Posts: 364
Re: How Low are CD4's When Problems Start
« Reply #7 on: June 12, 2006, 08:05:25 PM »
Hey David,

I'm a Psoriatic.  My psoriasis got much worse, I mean, REALLY bad,  as my viral load increased, while my cd4s hovered around the 300 mark the entire time.  I started meds, and I have gotten significantly better as the viral load has gone down.  Based on what I have seen, I don't think the dermatologic problems are related to CD4s like OIs are,  but rather, to the viremia itself.  My dermatologist confirmed this on my last visit, stating it is not uncommon for skin conditions (as opposed to dermatologic disorders of connective tissues like rheumatoid arthritis) to improve remarkably when the viremia is under control.

It seems we are learning as we go along that the virus causes a lot more damage to us than just the effects on CD4s.

-Whizzer

Offline heartforyou

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  • Posts: 1,105
  • I must be a survivor in many ways...
Re: How Low are CD4's When Problems Start
« Reply #8 on: June 13, 2006, 04:09:49 AM »
From my own experience I must say that a lot can be helped by what you eat and drink.
One very important point is to keep a good balance in your alkaline/acid household.
Read about it and you will understand.

I have seen my skin grow thinner and dryer over the years. Thus scratching more easely and healing slower.
Might be the age as well.

Since half a year my breakfast consists of the following, as prescribed by a famous German doctor, specialised in treating cancer :

half a cup of sheep/goat yogurt
1 teaspoon of good honey
3 spoons of flaxseed oil
stir  all that well, then

add half a banana,
half a sliced apple
1 spoonfull of crushed flaxseed
1 spoonfull of wheatflakes
some dried fruit and nuts
All of it organic, when available.

It raises the oxygen level in your blood considerably and I find that my skin is by far not as dry as it used to be. And on top of that my energy levels have risen.

Skin needs to be nurtured : a good lotion and excercise, if possible, are a must as well.

When I was at 17 CD4 count my main problem where fungi in my mouth.

Hermie
« Last Edit: June 13, 2006, 04:14:03 AM by heartforyou »
Diagnosed in 1987 and still kicking
Viread, Kivexa (Epzicom),Viramune once daily

Happiness is the freedom of breathing fresh air every day.

Offline Markmt

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  • Posts: 179
Re: How Low are CD4's When Problems Start
« Reply #9 on: June 13, 2006, 07:02:05 AM »
Hi Dave, When I started treatment my cd4 was 165 vl 220,000. I had eczema and a general fatigue. Luckily no OP's. Eczema and fatigue improved after treatment,

mark
"Live to love and love to live."

Leo Buscaglia

Offline Nadine

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  • Posts: 1,253
  • Member since: August 2005
Re: How Low are CD4's When Problems Start
« Reply #10 on: June 13, 2006, 07:10:31 AM »
My husband had seborrheic dermatitis and rosacea.  Since he has been on meds, Truvada/Sustiva, it has cleared up. Don't know if maybe the Bactrim helped while he was on it too.

Offline fearless

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  • Posts: 2,191
Re: How Low are CD4's When Problems Start
« Reply #11 on: June 13, 2006, 07:35:24 AM »
hey David,
I have the same problem on my scalp, dry skin and eczema on the rest of my body. I thought I had grown out of both until HIV. When I started medication about 6 months ago it actually got a lot worse until just recently when it has started to clear up. I've shed enough skin in the last 6 months to make any snake envious.
There are any number of pills, potions and lotions out there on the market.
To help mine I stear clear of soap and any soap products, and try to keep my showers short and warm, as opposed to hot. Most common soaps actually contain skin irritants as the ingredient that makes it foam and look nice and hot water destroys and washes off the bodies natural oils.
Steve
Be forgiving, be grateful, be optimistic

Offline heartforyou

  • Member
  • Posts: 1,105
  • I must be a survivor in many ways...
Re: How Low are CD4's When Problems Start
« Reply #12 on: June 13, 2006, 07:50:22 AM »
Steve,

Interesting you mentioning not using soap.
I haven't used soap for bodywash in almost 30 years now.And have not gotten any complaints...lol
Only use shampoo for what is left of my hair.

Sure is that many soaps take away the protective layer of you skin and unbalances the acidity of it, thus making it shed and feel rough.

Hermie
Diagnosed in 1987 and still kicking
Viread, Kivexa (Epzicom),Viramune once daily

Happiness is the freedom of breathing fresh air every day.

Offline livingpositively

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  • Posts: 369
Re: How Low are CD4's When Problems Start
« Reply #13 on: June 13, 2006, 05:31:15 PM »
When I had my first meeting with my Dr. and his nurse (who won the Milwaukee nurse of the year award.  She's awesome), in the conversation about meds, the discussion was that as long as "the numbers" are ok no need for meds, unless something like thrush or other OI manifests itself - even if "the numbers" are still good.  I took that to mean that certain OIs are posible even if the CD4 count and other numbers are good.

Good luck,

Shane
4/6/07   CD4 450, % 23, No VL
2/19/07 CD4 487, % 26, VL 47,500
1/4/07   CD4 357, % 27, No VL
10/3/06 CD4 500, % 26, VL 18,000
7/6/06   CD4 530, % 29, VL 83,800
4/6/06   CD4 555, % 28, VL 13,000

Offline CowboyPOZ

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  • Posts: 61
Re: How Low are CD4's When Problems Start
« Reply #14 on: June 14, 2006, 01:53:49 AM »

Buddy I feel your pain. I have been to 3 dermatologists who say there isn't much they can do. There is a great lotion you can have them give you a perscription for which is called Clobex. It has helped immensely with my Eczema but the red patches are still a pain.

Another good friend is Cetophil antibacterial body bar soap. It sure helped me out. I am also in the higher CD4 range and noticing these problems.

It kind of feels like being a teenager all over again! I only wanted to go through that once.

Best of luck and let us know if you find a good combination which helps you!

Okie Cowboy Guy

Offline joemutt

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Re: How Low are CD4's When Problems Start
« Reply #15 on: June 14, 2006, 02:24:06 AM »
I have this skin thing on my scalp I cannot get rid of and something between 2 toes same, but cd 4 1250, so yes, I think it's possible.

Offline penguin

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  • The Penguin Whisperer
Re: How Low are CD4's When Problems Start
« Reply #16 on: June 14, 2006, 04:30:54 AM »
Quote
Most common soaps actually contain skin irritants as the ingredient that makes it foam and look nice and hot water destroys and washes off the bodies natural oils.

that'll be the sodium lauryl/laureth sulphates for you, steve... :)
a good point, and worth remembering that there are products available which don't contain these...Green People http://www.greenpeople.co.uk and other brands like them are worth looking at if your skin is particularly reactive.

Kate

Offline J.R.E.

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  • Joined Dec-2003 Living positive, since 1985.
Re: How Low are CD4's When Problems Start
« Reply #17 on: June 14, 2006, 07:58:28 AM »
Hello David,

 Thats tough to answer. In 1999, I had a t-cell count in the 900 range, and was doing quite well. By October of 2003 t-cells were at 16, viral load 500,000.

Beginning around 2001, is when fatigue started setting in. Toward the end of 2002, weight loss started. The fatigue also got much worse, but I was not uncomfortable, It just took everything I had to get moving. For me, it was the esophogeal thrush, which really did me in, around July of 2003, then shortly after that Bacterial pneumonia (which hospitalized me for 23 hours, with an IV, and anti-biotics) That cleared up, then shingles started again, and my lips broke out terribly ( I mean VERY badly). Medication, was started, very shortly after that. I know a lot of this probably isn't pleasant to read, but, that was my situation.


Ray


Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 12/10/14,  t-cells are at 350,  Previous 8/25/14--- 402/ Viral load remains <40

 Current % is at 13% / Previous 8/25/14 11%

  
 63 years young.

Offline J.R.E.

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  • Posts: 7,280
  • Joined Dec-2003 Living positive, since 1985.
Re: How Low are CD4's When Problems Start
« Reply #18 on: June 14, 2006, 08:02:13 AM »
David,

 I have got to add this also. If I had not gone into denial after 1999, I may have prevented a lot of the damage that occurred. That was my mistake.

Ray
Current Meds ; Viramune, Epzicom, 40mg of simvastatin, 25 mg of Hydrochlorothiazide.
Metoprolol tartrate 25mg



http://forums.poz.com/index.php?topic=40802.0

http://forums.poz.com/index.php?topic=45159.0

http://forums.poz.com/index.php?topic=39722.msg495621;topicseen#msg495621

http://forums.poz.com/index.php?topic=46806.0

http://forums.poz.com/index.php?topic=39414.msg491701#msg491701


Diagnosed positive in 1985,.. In October of 2003, My t-cell count was 16, Viral load was over 500,000, Percentage at that time was 5%. I started on  HAART on October 24th, 2003.

 As of 12/10/14,  t-cells are at 350,  Previous 8/25/14--- 402/ Viral load remains <40

 Current % is at 13% / Previous 8/25/14 11%

  
 63 years young.

Offline allopathicholistic

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Re: How Low are CD4's When Problems Start
« Reply #19 on: June 16, 2006, 08:26:20 AM »
Another good friend is Cetophil antibacterial body bar soap. It sure helped me out.

Cetaphil makes great stuff - never heard of that one til now - sounds good

Johnson's Head to Toe Baby Wash is the bombdiggity (hey, if it's good enough for a baby's butt.....!!)

(for lotions i give blue ribbons to Curel's Continuous Comfort and regular Aveeno)

Offline wellington

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  • Don't sweat the little things.
Re: How Low are CD4's When Problems Start
« Reply #20 on: August 24, 2006, 02:33:28 PM »
Some threads deserve to be printed and sent to the dermatologist before one's appointment. Such is the state of medical care these days.

I'm feeling particularly grumpy today because I waited 3 months to see a dermatologist for what was suspected to be Eosinophilic folliculitis only to have him want to do a biopsy to confirm what he thought would not last more than a few more weeks. Why bother!? I could have just as well stayed in bed and watched Wyle E. Coyote try to cath the Road Runner for yet the bizillionth time. Another waste of time on a medical appointment that I had diagnosed myself using the internet - yeah, I know, I shouldn't be playing doctor, but I sure wish THEY would! Being dismissed after only 10 minutes in their office sure makes my blood boil at times.

The dermatologist did recommend an over the counter benzoyl peroxide (5%) though to help clear up the skin.

Thanks for admitting to not using soap Hermie. Aside from shampoo, I'm in that camp as well, and loving it. Still no dirty looks on that from others either - at least that I've noticed.

Offline RapidRod

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Re: How Low are CD4's When Problems Start
« Reply #21 on: August 24, 2006, 08:13:35 PM »
allopathicholistic, can't picture you having a pimple, let alone anything else.  ;)

Offline Life

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  • Member 2005
Re: How Low are CD4's When Problems Start
« Reply #22 on: August 24, 2006, 08:29:23 PM »
ahhhhhh "pube"rty Rapidrod...

 


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