new cd 4 guideline is 350?

[paradiseboy]

hi everyone was away for a while  hope everyone is  strong and healthy.iam back thanks to mobile internet.is the marked guideline to start arv  is 350 CD4 i thought it was when CD4was below 200? i have bacterial neumonia which iam very concerned my last cd4count was 180 and the doc says it could be cos of the neomonia the sudden drop from 410.took another cd count have to wait till friday and decide to start tratment  thanks everyone!

[Matty the Damned]

hi everyone was away for a while  hope everyone is  strong and healthy.iam back thanks to mobile internet.is the marked guideline to start arv  is 350 CD4 i thought it was when CD4was below 200? i have bacterial neumonia which iam very concerned my last cd4count was 180 and the doc says it could be cos of the neomonia the sudden drop from 410.took another cd count have to wait till friday and decide to start tratment  thanks everyone!

Last I checked the consensus seemed to be 500, but who can say? Doctors are such dilettantes.

MtD

[tednlou2]

I've been seeing some online docs/experts say new guidelines say to start between 350 and 500.  It confused me as well, because I thought the new recommendation was to start at 500 with half suggesting to start above 500.  I guess I need to read the new guidelines again, because they confused me with saying anywhere between 350-500.  Did WHO raise their level from 200 to 350?   

I'm sorry to hear about the pneumonia.  I got bacterial pneumonia and had a CD4 of 171.  They told me being sick probably temporarily dropped my CD4 to that level.  Sure enough, my numbers rebounded.  That was off meds.  I'm not sure what your situation is, but I don't think it matters whether your on meds or not--an illness can drop your numbers temporarily regardless, right?  You can see I'm asking more questions than answering, because I'm still learning about all this.

Anyway, I wish you a good recovery and good health.  How bad was your pneumonia.  You said you "have" pneumonia.  Sounds like it is being treated and it didn't get that bad where you had to be hospitalized??       

[Matty the Damned]

I've been seeing some online docs/experts say new guidelines say to start between 350 and 500.  It confused me as well, because I thought the new recommendation was to start at 500 with half suggesting to start above 500.  I guess I need to read the new guidelines again, because they confused me with saying anywhere between 350-500.  Did WHO raise their level from 200 to 350?   

I'm sorry to hear about the pneumonia.  I got bacterial pneumonia and had a CD4 of 171.  They told me being sick probably temporarily dropped my CD4 to that level.  Sure enough, my numbers rebounded.  That was off meds.  I'm not sure what your situation is, but I don't think it matters whether your on meds or not--an illness can drop your numbers temporarily regardless, right?  You can see I'm asking more questions than answering, because I'm still learning about all this.

Anyway, I wish you a good recovery and good health.  How bad was your pneumonia.  You said you "have" pneumonia.  Sounds like it is being treated and it didn't get that bad where you had to be hospitalized??       

It's always about you, isn't it Teddy? 

MtD

[tednlou2]

It's always about you, isn't it Teddy? 

MtD

Matty, I can never tell when your joking and when you're not. 

[Matty the Damned]

Matty, I can never tell when your joking and when you're not. 

That's part of my charm.

MtD

[tednlou2]

That's part of my charm.

MtD

I will say I'm amazed by your speed.  From the time I hit post to going back out to the list of threads, you had already posted.  Look at the time stamp--less than 1 minute.  Do you see what we're writing as we write it?  

Anyway, Paradise, I hope you're feeling better.

Modified:  My mistake, just over 1 minute.   

[Matty the Damned]

I will say I'm amazed by your speed.  From the time I hit post to going back out to the list of threads, you had already posted.  Look at the time stamp--less than 1 minute.  Do you see what we're writing as we write it?   

Anyway, Paradise, I hope you're feeling better. 

It's amazing how quickly you can do things when you don't have your head stuck up your ass.

MtD

[tednlou2]

It's amazing how quickly you can do things when you don't have your head stuck up your ass.

MtD

Okay, I'm signing off tonight.  We've already muddied up this thread.  Matty, I try to understand your humor and have come to enjoy some of your humor, but it is obvious you're not kidding.  The point of these threads, I thought, was to discuss things about HIV and shared experiences.  He seemed concerned about the drop in CD4 from pneumonia, so I wanted to let him know that my numbers rebounded.  We all talk about our own experiences.  Most of the threads I create are not about me.  They are about stories in the news about HIV.  And even if it was always about me, the comments were not necessary.  It didn't add anything to the discussion.  I only got 3 hours of sleep, so maybe I'm a little sensitive tonight.  If I'm misreading your humor, I apologize.     

[Matty the Damned]

Okay, I'm signing off tonight.  We've already muddied up this thread.  Matty, I try to understand your humor and have come to enjoy some of your humor, but it is obvious you're not kidding.  The point of these threads, I thought, was to discuss things about HIV and shared experiences.  He seemed concerned about the drop in CD4 from pneumonia, so I wanted to let him know that my numbers rebounded.  We all talk about our own experiences.  Most of the threads I create are not about me.  They are about stories in the news about HIV.  And even if it was always about me, the comments were not necessary.  It didn't add anything to the discussion.  I only got 3 hours of sleep, so maybe I'm a little sensitive tonight.  If I'm misreading your humor, I apologize.      

Let me know when you do something other than "share your own experiences" and I promise I'll dance at your gay wedding same sex civil union.

MtD

[emeraldize]

January 10, 2011
Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents Page 27
Initiating Antiretroviral Therapy in Treatment-Naïve Patients (Updated January 10, 2011)
Panel’s Recommendations:
• Antiretroviral therapy (ART) should be initiated in all patients with a history of an AIDS-defining illness or with a CD4 count <350 cells/mm3 (AI).
• ART is also recommended for patients with CD4 counts between 350 and 500 cells/mm3 (A/B*-II).• ART should be initiated, regardless of CD4 count, in patients with the following conditions: HIV-associated nephropathy (HIVAN) (AII) and hepatitis B virus (HBV) coinfection when treatment of HBV is indicated (AIII).
• A combination antiretroviral (ARV) drug regimen is also recommended for pregnant women who do not meet criteria for treatment with the goal to prevent perinatal transmission (AI).
• For patients with CD4 counts >500 cells/mm3, Panel members are evenly divided: 50% favor starting ART at this stage of HIV disease (B); 50% view initiating therapy at this stage as optional (C) (B/C-III).
• Patients initiating ART should be willing and able to commit to lifelong treatment and should understand the benefits and risks of therapy and the importance of adherence (AIII). Patients may choose to postpone therapy, and providers, on a case-by-case basis, may elect to defer therapy based on clinical and/or psychosocial factors.
Rating of Recommendations: A = Strong; B = Moderate; C = Optional
Rating of Evidence: I = data from randomized controlled trials; II = data from well-designed nonrandomized trials or observational cohort studies with long-term clinical outcomes; III = expert opinion
* Panel members are divided on the strength of this recommendation: 55% voted for strong recommendation (A) and 45% voted for moderate recommendation (B).

[aztecan]

All of the doctors in this area initiate treatment once the CD4s drop below 500.

There are exceptions, such as when the patient clearly isn't capable of adhering to the regimen, or they have untreated substance abuse issues, etc.

But, generally, people start once they drop below the magic 500.

HUGS,

Mark

[drewm]

A cat fight a week on these forums....

[BobF]

Yes, it's a shame how some bitter people are dismissive, critical, or sarcastic about posts that they don't write (LOL) or agree with.   What's worse is that they are this boards celebrity commentors on every subject.   When is the ignore feature returning, for those of us who seek information without the mean sarcasm of some?

[thunter34]

Yes, it's a shame how some bitter people are dismissive, critical, or sarcastic about posts that they don't write (LOL) or agree with.   What's worse is that they are this boards celebrity commentors on every subject.   When is the ignore feature returning, for those of us who seek information without the mean sarcasm of some?

I'll never understand why people can't just....ya know...shift their eyeballs.

[BobF]

I'll never understand why people can't just....ya know...shift their eyeballs.

Probably because the mean sarcasm never gets let go, but goes on and on - or just moves to another thread. Ignore worked great, IMHO

[TabooPrincess]

It's 350 here in the UK

[drewm]

 

I had trouble finding the "rolls eyes" LOL!