Dogman:
Good morning, I would like to give an update on my recent switch from Biktarvy to Dovato.
I have been on Dovato now for a month, after being on Biktarvy for 9 months (initial treatment).
my VL stayed UD, my CD4's however dropped from 470 down to 400, and my CD4/CD8 % dropped from 17% to 14%. I have had a cold for about 1.5 weeks, which I'm hoping is the reason for the downtown in CD4's
Otherwise, the switch was without side-effects. I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).
I hope everyone is doing well
Jim Allen:
I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise?
Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.
Are worried about CD4 counts and if so why?
Dogman:
--- Quote from: Jim Allen on September 22, 2023, 12:30:43 pm ---I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise? --- End quote ---
Apart from a cold, I feel just fine physically, I struggle big time mentally, which is slowly going away.
--- Quote ---Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.
--- End quote ---
No, I didn't expect anything CD4 wise from the new med, I'm happy i'm still UD. I have read many posts on CD4 count and while I was hoping for an increase, simply because they haven't gone up in 6 months, I'm not panicking about it.
--- Quote ---Are worried about CD4 counts and if so why? --- End quote ---
I am not particularly, I would like them to be in the "normal" range, but I guess that will come with time and patience.
Thanks for replying, hope you're doing good too!
leatherman:
--- Quote from: Dogman on September 22, 2023, 12:19:30 pm ---I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).
--- End quote --- ugh. this is one of those wrong "hopes" I wish doctors would explain better.
ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.
Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.
Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.
Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.
cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves. ;)
Dogman:
--- Quote from: leatherman on September 22, 2023, 04:25:12 pm ---ugh. this is one of those wrong "hopes" I wish doctors would explain better.
ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.
I do understand this, I was just being hopeful that my CD4 rebounded rather than went backwards. But yes, apart from a pesky cold in the past week, I have felt perfectly normally physically.
Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.
Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.
Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.
Please, never apologize, you do not bore me. I have read your posts over and over. I regard guys like you very highly, I have a couple of friends, who like you, went through the wars and are like you, still here, healthy and happy. I know we have it "easy", with the modern medicines etc.
cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves. ;)
--- End quote ---
Thank you, my doctor doesn't want to see me for 3 months, and yes, he also stated being UD is what to focus on. So thank you again, for your insight and reality check, I don't mean to sound like a whiney baby - it's just a struggle at times, I appreciate you and your valuable wisdom and experience.