My First Blip

[daveR]

Did my 6 monthly check, all become very routine with the results all ways being anticipated in advance. Waited for the paperwork, CD4 count 795 at 40%. All normal, checked the viral load, undetected for 6 1/2 years. Got a level of 27. Now even though I know that is absolutely nothing and still classed as undetected I was wandering around the hospital like Mr Bean.

Decided to speak to the Dr, she guessed the issue when I went in. Explained it was nothing, no further testing required until my next routine test. Even said that as of late many of her patients were getting blips and she actually thinks it is something they are doing in the laboratory.

It is strange though as when I read on here of others having blips and worrying I always think, nothing to worry about. When the shoe is on the other foot it is a different story.

Dave

[Jim Allen]

[daveR]

That summed me up and also what my Dr did about it. 

[Jim Allen]

That summed me up and also what my Dr did about it. 

  LOL.

27 isn't even a blip in my book, but I can understand the initial reaction and am glad to hear your Dr kept their calm.

It is strange though as when I read on here of others having blips and worrying I always think, nothing to worry about. When the shoe is on the other foot it is a different story.

Yeah, knowing something and living through it is different.

Now you have experienced it, and that experience might be useful when talking with others going through the same in the future.

How are you feeling/doing otherwise?

[daveR]

Feeling good in general thanks for asking.

The only other issue was the creatinine levels still. 1.24 on a scale with a maximum of 1.18. The switch to Triumeq made no difference there. The Dr is not bothered by it as it is stable at that and I have no protein in the urine. All other numbers withing normal range, kidneys, cholesterol. No complaints.

And you are correct, talking about it and experiencing it are two different things.

[Jim Allen]

Feeling good in general thanks for asking.

The only other issue was the creatinine levels still. 1.24 on a scale with a maximum of 1.18. The switch to Triumeq made no difference there. The Dr is not bothered by it as it is stable at that and I have no protein in the urine. All other numbers withing normal range, kidneys, cholesterol. No complaints.

Glad to hear that you are generally feeling good 👍

[leatherman]

Yeah, knowing something and living through it is different.

ain't that the damn truth.

as someone who has had several blips through the years (1500, 2500, 79000) and too many of those pesky Micro-Blips™, I've always warded off the worries with a little science.

first off, that test result is just a snapshot of that one moment in time when your blood was filling up the vial; and in the human body, things are changing all the time. Temp, BP, weight, and all that stuff that comes back from a CBC. CD4s, and even VL, are potential changes too. CD4s can change by 100 pts a day, so they're really not a great way to measure someone's "healthiness". Knowing we have reservoirs of latent HIV residing in us means there's always a chance your blood was taken as a little bit of HIV was floating around in the process of your meds tackling the issue.

As far as science, "successful HIV treatment" is considered to be a viral load of 200 or less. That's why Micro-Blips™ (VL <=200) mean nothing. Then there's always lab errors. They're rare; but they happen. A good way to view you VL, and your CD4, is by the trend of at least 3 tests over at least 6 months. Remembering to not focus on just one test result (a moment in time) and considering the change through an amount of results over enough time can give you a better view of what HIV and your immune system are really doing.

needless to say, getting a micro-blip, or a super-duper blip, is troubling; but until your VL jumps up into the 10s of 1000s while your cd4s plummet below 200, you just have to hold off a conclusion (and your worries) until you get your next results. As time goes by (gaining experience) it really does get easier to not worry about this stuff as much.

[Jim Allen]

super-duper

Okay, so a tad off-topic, but given we already mentioned Mr Bean (Rowan Atkinson) and now reading you mention super-duper, it gave me a flashback to "Not The 9 'O Clock News" from 1981/2 ? With Rowan Atkinson and their parody Of Super Trouper By ABBA.

https://www.youtube.com/watch?v=wYkxvU66c3s

[daveR]

Golden oldies. I think I actually remember watching it on TV.

If we can't maintain our sense of humour about things, all would be lost.

[daveR]

To save starting another topic entitled My Second Blip I shall continue on this one.

My micro Blip has grown from 27 to the heady height of 210. I am still on Triumeq, two pill version. My Dr is still not concerned but has asked me to go back in three months instead of the usual six months. Strange that for over five years I was undetectable on Complera but had my first Blip one year after starting Triumeq. My CD 4 count is excellent at 1140 but the viral load does concern me a bit.

The other thing that niggles me is we changed from Complera to Triumeq as my serum creatinine level reached 1.33 and the Dr was concerned. On Triumeq it is now 1.35 and she has no issue with it. The old saying if it's not broken don't mess with it springs to mind. She doesn't appear to be very consistent with her opinions.

Not stressing over it yet, but see what happens in three months time.

Best of luck to all
Dave

[leatherman]

My Dr is still not concerned but has asked me to go back in three months instead of the usual six months.

As mentioned before successful HIV treatment is considered to be a viral load of 200 or less. 210 is just too close to 200 to set off any warnings or concerns for your doctor. Especially if you're going to test earlier next time.

Every 6 months? I would love that. Because of Ryan White measurement rules, I have to go every 3 months - which quiet frankly, being compliant to daily meds, seems a total waste of resources and my time for someone living with HIV for 39 years.

[daveR]

Thanks leatherman, I just looked up the 200 limit and it seems that many institutions call anything below 200 suppressed and under control. My Dr did mention up to 1000 doesn't surprise her. 

[Mindless]

Hello Dave,

Always nice to read your comments. I had my first blip at my previous 6 months check, then the next one was back to UD. My Dr. had a similar reaction, nothing to worry about.

I also had a creatinine increase for the last 4/5 years, last lab was 1.33. My Dr also says nothing to worry about, but after 4/5 years of constant increase I insisted to be referred to a kidney Dr.: he told me it's most likely normal aging (I'm 54) and to keep monitoring. If it increases more, we could do some more specific lab. My next check is in 2 months.

I'm on a 2 pills version of Dovato for the last 2 years, previously 2 pills Complera like you.

[daveR]

Hi Mindless,

Glad Dovato is working out for you. I discussed that regime about a year ago with my Dr, she advised to stick with three drugs for now.

Hope your results are good in two months. I think one of the issues the like of us have is these regular medicals, probably a lot of people wandering around out there who have no idea what their creatine levels are so don't worry over it.

Dave

[Mindless]

Hello Dave,

With a bit of delay, I’m updating my info related to the creatinine issue. My last check at Red Cross last May was 1.24, still over the limit but lower than the previous (1.33). My hiv asked me to do also a check at another lab, which came back as 1.26, basically the same.

The kidneys dr he referred me to said that in some people DTG is known to slightly increase the creatinine. Honestly, I have some doubts about this interpretation, as my baseline values just after starting ARVs were below 1. However, he said that although values are over the limits, other labs do not show signs of kidney damage or illness, so he advises simply keep monitoring.

I guess I have to live with that