After First 3 months CD4 count

[nethan1621]

Hi , first follow up report after 3 months from diagnosed, shows V load <20 UD but CD4 goes down 704 to 625 . Has anyone experienced? Although every article says it’s normal from Dr google..   

And my eGFR lower to 87 min/ml from 120     

Im on Acriptega

[leatherman]

CD4 goes down 704 to 625 . Has anyone experienced? Although every article says it’s normal

Here's a lot of other cd4 info I pulled from previous replies I have posted:

cd4s are variable; they can change by 100 pts in a day

CD4 counts are best viewed as the graph of at least 3 tests over at least 3 months time. A one time test doesn't tell you much. It's always about the trend (up or down) over 3 or more tests.

the cd4 test is simply a snapshot of your cd4 count at that moment. Cd4s fluctuate all day long, and by up to 100 points either way. (lower in the morning, higher in the everning) Exercise lowers then raises your cd4 temporarily; while smoking will raise then lower the amount. there is no treatment for raising cd4s. All we can do is remain virally suppressed, through adherence to daily meds, so that our cd4s are allowed to flourish without being used up by HIV

because the immune system you have is based on your genetics, there is no magic number of cd4s. cd4s are a part of our immune system; therefore a cd4 count is not a measure of "healthiness" although the thinking is that more cd4s equals a more robust immune system. Being a quantitative measure not a quality measure though, the cd4 count does not reflect whether you have a strong/effective immune system. Some people with low cd4s are rarely "sick", while others with high counts can experience health issues. Having a high cd4 count does not mean you should feel well/healthy - that mainly depends on your food, exercise, and bad/good habits, although an immune system fighting off the germs does certainly help one to feel good

Your cd4 count from last time to this time only changed by 79 pts which is statistically nothing, so there is nothing to worry about

....actually your cd4 count has been bouncing all around every day from the last test to this one  ; but these are just the two times you've tested and compared the numbers. if you had tested any other day or at another time, you would have had different numbers.

[nethan1621]

This is the answer I really wanted to hear rather general basic everyday answers. For me this explanation is a kind of all in one answer.. thanks a lot…  appreciate…

[nethan1621]

Im on Acriptega DTG/3TC/TDF for 3-4 months now and my eGFR decreased. Before started my treatment it was 120ml/min and just after 3 months its lower to 87ml/min. As per dr it is still in good level ( above 60 ) . But it just the beginning and that much negative effect on kidney within 3 months would be a huge issue after several years… Anyone has experienced dramatic kidney issues similar to this within short time period? And those low filtering rate due to on going damage? 

Please …Anyone here from south africa ? Kindly let me know .. i buy my medicine in South africa and looking for alternative more kidney friendly Combination. I have heard about ABC/3TC/DTG combination called “Trelavue”, At least i can do a gene test for Abacavir… emailed to my dr but not yet reply about switching medicine…

If it was tiredness, insomnia or nausea etc still we can manage but something directly harm to organs while there are alternatives, im ok to switch medicine under dr supervision.


Please reply here or PM me with your experience if you ever faced similar  and switch medicine successfully..your experience could save me before its too late for me..at least i can do something now.

Thank you

[Jim Allen]

Hiya,

Can tell that you are worried about this.

Few things to keep in mind is the value is within the normal range, it's only a single snapshot moment and you only just started treatment.

I would say wait and see what your next lab results are like. I've had better and worse ones than yours over time.  If the next results are lower again then I might consider switching to something that does not have TDF if I was in your shoes.

If it was tiredness, insomnia or nausea etc still we can manage

I have had fatigue lasting 18 months that would make you wish you would no longer want to wake up anymore and insomnia that makes would make you want to cry and beg for sleep. I would not dismiss the impact these things can have on a person as "manageable" issues unless the person themselves experience it as manageable and I would have gladly accepted a snapshot lower but within the normal range result over these issues.

I have heard about ABC/3TC/DTG combination called “Trelavue”, At least i can do a gene test for Abacavir… emailed to my dr but not yet reply about switching medicine…”

So the HLA-B*5701 testing is for ABC hypersensitivity. The combination mentioned is the combination I have been taking for the last few years. It's great for me but it does not suit everyone, like any combo I suppose it would not suit everyone.

The brand version of this combination is called Triumeq https://www.poz.com/drug/triumeq

I would not be looking at switching if I was you so soon, but at the end of the day you need to manage your own care and what works for you.

Best, Jim.

[nethan1621]

I would say wait and see what your next lab results are like. I've had better and worse ones than yours over time.  If the next results are lower again then I might consider switching to something that does not have TDF if I was in your shoes.

I would not be looking at switching if I was you so soon, but at the end of the day you need to manage your own care and what works for you.

Thank you for your answer.

True … anyway when i meet dr next time it will be 6 months and hopefully it will be UD status. This is the most important thing from a forum , just to understand what’s happening with others and experience which are very useful person like me whos new to this… even when i discuss with my dr , at least i have an idea that there are other option…

DTG/3TC will be same TDf will be change and if it is not too risky for resistance thing, or that much harmful to switch after six month, i would suggest my dr and see… like you said , if it is again bad in my report, should be changed rather being sorry later ..

Thank you for your answer with your experience…

[Jim Allen]

This is the most important thing from a forum , just to understand what’s happening with others and experience which are very useful person like me whos new to this… even when i discuss with my dr , at least i have an idea that there are other option…

Yeah, as long as you take what people have experienced with a healthy dose of salt.

Look millions of people take over the counter ibuprofen every day, works fine. I also know people who are allergic and had bad reactions. Their good or bad experience does not mean much to me.

The point being and I know my explanation is short but if you are shopping for bad or good experiences you will find them for everything.

DTG/3TC will be same TDf will be change and if it is not too risky for resistance thing, or that much harmful to switch after six month, i would suggest my dr and see

DTG & 3TC is a possible combination. Not sure if that's an available option in South Africa though? Maybe someone will chime in on that. That said if everything might remain fine on your next lab results.

[harleymc]

Every body responds differently.

While i hit that Vl sub 20 Mark fast,  it took years AND years before my CD4 count reached 100.