curious about my last results + tb

[iceborn]

Hello. I'm not sure if i'm posting in the right section since i was diagnosed 2 months ago, so feel free to delete/move the topic.
Well, it all starts with getting diagnosed on september 25. After that, i went to an STD clinic to try and start treatment soon. After a few misscheduled appointments, i finally got the chance to see a dr on october 30th, who told me she would only prescribe after the she got the results for the  viral load/cd4 count test plus other (stool, urine, bloodwork and tb) ones. Treatment is free where i live (Brazil) but certain procedures(like scheduling an appointment and cd4/v.l. results) take a lot longer than usual. So today i went to the clinic to get the skin TB test and they scheduled my first appointment to jan. 29, which means ill have to wait 2 more months to start treatment.

Also, there are other issues:
1.  I might  have been infected a long time ago, around august 2013. Long story short, i had (receptive) anal sex 4 times between feb 2012 and jan 2014. All of these times it started with a condom but this particular time in aug 2013 i heard a weird pop, and felt something but i didnt look back. I believe this person infected me on purpose, and then around this period i got very sick but the doctor prescribed antibiotics so i'm not 100% sure if it was seroconversion or not. After  the 4 times i never had anal sex again(nor any kind of sex involving penetration) but i had unprotected oral sex and rubbing, not sure how risky that could be though.

2 - ive been having this tickly feeling in my throat for  two weeks. its not all the time and its not too severe, but sometimes i have to cough to relieve it. no phlegm. yesterday i also started having a weird feeling in my chest. like sometimes it feels like a tightness, sometimes it feels like a shortness of breath but not quite.  im trying to rule out reflux and anxiety but im scared it could be something ugly like tb or pcp.

sorry for the big wall of text but i needed to vent a little.
so back to my request, i know you guys dont like playing online doctor but its the only thing i have right now. id just like to know what i can do to avoid getting sick (not cold-sick or allergy-sick, but im talking about something more dangerous) while im not on treatment, and what are common symptoms of OIs/full blown AIDS so i can avoid starting treatment too late. thank you and sorry if anything i wrote doesnt make sense but im really nervous right now

[Jim Allen]

I'm at work so can't write a book write now but welcome to the forum and I am sure other members will comment later in support.

So if i get you correctly your not on treatment yet, plan is 29th of Jan 2018 and you are feeling sick and its scaring you and you are trying not to panic.

Go see a GP or primary care person to treat whatever is making you ill in the first place that would be my advice. HIV specialist sounds like a long wait and if its anything like my nations health system they deal with HIV not other day to day infections. Look people with or without HIV get sick and trying to figure out if its caused by HIV or not is pointless, infections that you pick up or have picked up should be treated before it gets worse.

full blown AIDS

I hate that word, not AIDS as such but full blown is very 80's but maybe that is just me.

Anyhow welcome to the forum and I am sure others will chime in, however you are correct playing doctor online is not something we encourage

Jim

[Tonny2]

      ojo      Ola e ben-vindo aoo Forum, meu amigo...i'm sorry about your dx, but i'm glad you found us, here you will find information and suppot, you are not alone anymore.

Well, an advice, if i may, try to avoid missing appoinments, hiv is a serious infection, especially when you don't know the facts of your situation...let's wait and see what your specialist tells you, i don't think there is much you can do...usually, when we find out about our hiv dx, we feel all kind of symptoms, so, if you think that your symptoms aren't going away and they are getting worse, see your family doctor...my experience with PCP, if you were to have it, you will start losing lots of weight, just keep an eye on that...if you think you were infected during those dates, i don't think you will be diagnised with AIDS, i know we all are different, but i'm trying to be positive, no pun intended...we have another brasileiro aqui, maybe, he will contact you to share his expeience with you about the medical services in Brasil, to help you and make it easier for you with this new journey you are about to start...do not worry, everything will be ok, you have done the most important step, getting tested, now you know you go it, now you treat it...wishing you the best...boa sorte e abbracos                                 

[iceborn]

Ok im typing from a phone so i can quote properly.
Jim: thank you for the kind words and advice. i was really out of my mind when i started the topic. On the bad language im sorry, didnt know what. will refrain from using these unnecessary words from now on 


Tonny: Oi! thank you. i hope he reads it and pms me soon so i can at least have some local tips. abraços

[Tonny2]

      ojo.    Oí amigo, I already sent cesar_camargo a PM, letting him know about you...in order for you two to communicate via PM, you need to have posted three times...boa sorted, obrigado...tchau.          ojo

[iceborn]

so do 1 post and 2 replies count as three? if so i should be good now
thanks again for the info Tonny

[cesar_camargo]

First things first....

Calm down , stress can have only have a bad impact at these times.
My first comment/question/advice is... if have any sort of insurance use it. In these years I've seem a lot of brazilians who, afraid of being of having their status 'discovered' by employees or family, use the public health system instead their insurance.

Then for your symptons, I'll go with Jim's advice, seek out threatment for whatever you're having, since u'll have to wait to 28th jan... don't let it get worse till there.
The infectologist there would tecnicly take care of that, but if u can get it threated now... no reason to wait.

Here the specialist in hiv becomes also your 'every-day clinic' doctor, whenever you got anything that's where you run to, if he believes u need any other speciality he'll send u there.

PS: for everything u typed... u seem to be far far away from 'full blown aids', so just try to relax a bit

[Tonny2]

so do 1 post and 2 replies count as three? if so i should be good now
thanks again for the info Tonny

        ojo     oi icebom...i suppose so, if you have a problem, let jimdubin know, por favor...i saw your compatriote replying already to you...nothing like someone from your neck of the wood, to assist better, maybe you two can chat via PMs, for some private things and suppot each other in your own language...please, relax, try to takw care of yourself, wash your hands everytime you are out from your house, don't eat food on the streets, deink bottle water, this little things will help you, until you know how bad is your immune system...p;ease keep us posted and remember, you can vent whatever you want...boa sorte and obrigado, no need to thank, that's  what friends are for...abracos                                                 ojo

ps. @cesar=camargo,,,obrigado pwla sua resposta rapida...abracos e beijos

[iceborn]

small update: tested positive in a skin TB test- so i'm getting my appointment next week. thank you all for your help

[iceborn]

So, i finally got to see my CD4 count and viral load after a month and 10 days. I'm not on treatment yet and wont be until jan 29.  My results were as follows: VL: 3005 and CD4 583(17.88%).
I had the opportunity to talk to a doctor since the result, but he was basically doing me a favor because a friend of mine asked (he didnt charge for the appointment and even got me a free chest x ray) and he was sort of running late so i forgot to ask everything i wanted to. However from what ive read my viral load is not high and my cd4 count is good, but my cd4% could be quite low. Does this "low" viral load mean i was recently infected - i.e., after reaching a peak during seroconversion the viral is brought down do minimal levels then climbs up to over 100000's, right? Also, is my cd4% low? Ive read confusing reports on whether or not a low cd4% means someone is immunocompromised despite high cd4 counts. Im just asking because im worried about TB as i had a positive skin test and a cough for more than a month now. Plus my body temperature has been weird lately, but i cant provide sputum for a smear and my chest x ray shows theres nothing wrong.

[Jim Allen]

Sorry to hear about the TB, when are you getting a following up on the TB part?

Anyhow there is noway of knowing from the VL or CD4 count how long you have been infected. Your VL settling point post infection can be very low and remain like that for a few months to even years, low VL or not it is still is doing damage and how low the VL settles at is very different per person.

Same can be said for total CD4 count noway of knowing how many CD4's you normally ranged at before the HIV infection and the counts can vary vastly on a day to day basis. A HIV negative people sit typically between 500-1200.

The CD4 percentage is more stable than the exact CD4 count, your test reports CD4% = 17%, that means that 17% of your lymphocytes are CD4 cells. The average normal CD4% for HIV negative adults is about 40%. (Ranges from 30 - 60%)

immunocompromised despite high cd4 counts

Yeah, I mean you always will belong to that group, you have HIV a group that is statistically challenged and more at risk. 

The term ‘immunocompromised host’ embraces a group of overlapping conditions in which the ability to respond normally to an infective challenge is in some way impaired.

This includes patients with underlying conditions such as protein–calorie malnutrition and diabetes, as well as organ transplant recipients, those with haematological malignancies and others receiving therapeutic immunosuppression, and patients with HIV infection. Many patients have multiple risk factors that increase the risk of opportunistic infection.

I think what you are really asking is not if you are classed as immunocompromised but if you have AIDS (Advanced HIV) or not?

That is a different question and depends on your definition, where i am from you could have 0 CD4's and no % and still not have AIDS unless you have an aids defining illness to go alone with it. This thread might be of interest to you but don't overthink it. http://www.thebody.com/Forums/AIDS/SafeSex/Q201608.html

The goal and your focus no matter what the VL remains the same start treatment as soon as possible, treat any co-infections and remain adherent to your meds. Wishing you all the best for the Jan appointment.

Jim

Visual Example:
https://upload.wikimedia.org/wikipedia/commons/d/d0/Hiv-timecourse-es.png

[iceborn]

turns out my hiv clinic is sort of messed up and i should have been on meds since my first appt. about the tb infection, they would only rush treatment if i was showing more symptoms of an active tb infection or if i had positive sputum tests/suggestive x ray findings which is not the case. so ill have to wait until my appointment to get the meds both for hiv and for a latent tb infection (this worries me but ill get to talk to the doctor about it al least)


by (more) immunocompromised i mean "less able to fight off OIs than someone else who has a cd4 count of 583 but a higher cd4%".

and thank you for your help and well wishes. happy holidays!

[Jim Allen]

Well you are  immunocompromised by definition but i now get where you are going I think.

First thing to get your head around is the CD4 count is not an indicator or health, and it does not tell the full story of the damage HIV does to the human body. 

That said your CD4 % is lower than best and the lower it goes statistically the higher risk you are at developing/catching OI's. When it drops further (will have to check the %) the odds or risk of having an OI increases and when the count is below 200 or % drops below 14% it increases the risk dramatically so,  now that does not mean illness happens to everyone with low values and there are many factors to this its just statistically the risk is greater, something you can avoid.

The focus here is to suppress the virus with treatment, in your body and bloods and let the body heal the damage as best it can, its not counting CD4 cells or focusing on the levels of CD4 %

Jim

P.S There is an entire section with 12 lessons under the main header "HIV treatment"  that also covers this and more should you be looking for easy to get your head around yet reliable information  https://www.poz.com/basics/hiv-basics

[harleymc]

Hi Iceborn,

I'm glad that your HIV has been diagnosed so that you can get treatment.

With your cd4 counts you are not at any immediate danger of becoming ill with an opportunistic infection. Don't get too hung up on percentages, there's nothing to be done to change the ratio.


The best thing to do will be fully adherent to your medication regimen when you start on it. That will improve the chances that your cd4 count will improve, but it doesn't guarantee it.


Testing positive on the TB skin test means one of two things, you have been vaccinated for TB or at some stage in your life you've been exposed to it. It doesn't test for any current TB infection. That's why you've also had a chest xray and sputum test to see if there's a current infection.

It sounds like you are in capable hands.  Have a joyous Christmas and a happy new year.