Boyfriend depressed over his latest lab numbers

[LadyMisty1207]

My boyfriend got his lab numbers today and he is totally depressed. His confirmation numbers back in May were VL65 and CD4 880. He has been on Atripla since June. His results from his blood work last tuesday show that his VL is now 660 and CD4 is 1100..

Can someone please help me to understand why the VL would jump so high instead of going down to undetectable?

Even his doctor is shocked and told him that he can re-test to make sure there is not a glitch.

[Almost2late]

If your BF got a flu shot just before his blood test, its possible it may temporarily elevate his VL.. Doc's right, a retest is in order.. On the bright side, I wish I had those CD4's 

[mecch]

My boyfriend got his lab numbers today and he is totally depressed. His confirmation numbers back in May were VL65 and CD4 880. He has been on Atripla since June. His results from his blood work last tuesday show that his VL is now 660 and CD4 is 1100..

Can someone please help me to understand why the VL would jump so high instead of going down to undetectable?

Even his doctor is shocked and told him that he can re-test to make sure there is not a glitch.

This is his first blood test for numbers since starting meds? 

Also, 660 VVL is not a "jump so high" but I do understand you all were expecting undetectable.  When can he retest?

[LadyMisty1207]

@Atlmost2late no flu shot yet they don't have it in stock..@Mecch he can go back anytime to get it re-tested again..

I tried to explain to him that his cd4 is great so not too worry about getting sick cause I know that is what is making him depressed.

[Ptrk3]

A CD4 above 500 is the low end of normal.  He far exceeds that.  His CD4 is probably higher than the vast majority of HIV negative people.  His VL is nearly undetectable.  He is in great shape and probably not much long-term damage to his immune system.  He should be quite pleased, as pleased as you are.

[mecch]

@Atlmost2late no flu shot yet they don't have it in stock..@Mecch he can go back anytime to get it re-tested again..

I tried to explain to him that his cd4 is great so not too worry about getting sick cause I know that is what is making him depressed.

Well there's no point in waiting for the retest, or did the doctor give him an appropriate time?... 

[LadyMisty1207]

@ Mecch he is going to go this Friday when he takes a day off from work.

[mecch]

It really does take awhile for most HIV+ to calm down after a diagnosis and realise they are not about to fall sick and die. But IMO (just a stranger), with his numbers, he should not be worrying about getting sick because of HIV.  I mean come on. Has his doctor reassured him?  Is he aware of the facts bearing on his numbers?  Is this your interpretation of why he is depressed (fear of illness) or has he actually said so.

[LadyMisty1207]

@Mecch his doctor told him that if he is taking his meds on a daily basis then he doesn't have anything to worry about cause his cd4 levels are good. Yes he does understand the facts of his numbers. He broke down and cried on the phone with me when he told me his results. He has told me before this that he is a little depressed about having to deal with being pos..I have advise him to get some therapy to help him.

[zach]

your boyfriend has GREAT numbers... i'd kill cute fuzzy bunny rabbits for half of his cd4

prop him up for a minute, build his self confidence. keep him upbeat and positive. he's still reeling from the dx, it is a mind fuck

his VL is NOT high, his cd4 is NOT low... hold fast and stay the course, he is winning the fight

[mecch]

He has told me before this that he is a little depressed about having to deal with being pos..I have advise him to get some therapy to help him.

Well its probably not principally a fear of getting sick, yes, its probably more all the other adjustments to being HIV+ for the rest of one's life.

[leatherman]

Can someone please help me to understand why the VL would jump so high instead of going down to undetectable?

it's simply because labwork is not a straight line function. There can be downs AND ups on the way to undetectable. There's no set time either for when UD might happen.

during any day for an HIV positive person, the small reservoirs of HIV in our system could spillover, creating a slight uptick, that could be noticed if that was the exact time blood was taken. CD4s counts are even more maddening because they can change by 100 points within a single day.

Our bodies are always in a state of flux (your weight changes throughout the day ) and a single number shouldn't spark any reaction - good or bad. To get a feel of exactly what is happening with viral loads and cd4s counts (and other counts, but these are the ones pertinent to this conversation), you need to look at the trend of 3 tests taken in a 4 to 12+ wks interval

I would also point out to not focus on the cd4 count so much (especially once on treatment and >200). "Normal" (whatever that means) is anywhere from 500- 1500. Without having a cd4 count from BEFORE being hiv positive, there is no way to know what a person's "normal" is. Nor is there a good way to measure the strength of someone's cd4 cells. Some people with low (300-400) are incredibly healthy while some with high counts (1000-1800) have constant health issues. It's all about the genetics and there's no measure for that right now. 

hopefully knowing his counts are GREAT and that the trends are going in the right direction can help with some of that depression.

[LadyMisty1207]

Thank you Zach, Mecch and Leatherman..I am trying my best to keep him as upbeat as possible..and I do agree with Mecch that he having a hard time adjusting to his diagnosis still..

[zach]

of course he is... how are you holding up?

[Joe K]

Hello Lady,

Please try and have your bf read this post.  A viral load of 660 is nothing, really.  Yes, it is not undetectable, but it is so low that it's not going to compromise his health.  Certainly not with that CD4 number of 1100.

Since he's newly infected, it will take him some time to understand his lab results in relation to their relevance.  Lab results are but one indicator of our health and one set of labs is never a reason to become overly concerned.  What we want to see are trends and I expect your bf will see his VL continuing to go down and his CD4s may even dip.

This is good news.  It confirms that his immune system is working as designed.  He may lose CD4s as they halt HIV replication, however, once he reaches undetectable, his CD4s will most likely rebound, because his counts are very good.

Tell him for me, that his labs are great and he is in no danger whatsoever.  Ask him to come here, when he feels afraid, so we can help him to keep it all in perspective.

Reactions like his are very common when first diagnosed, so please don't be overly concerned.  Adjusting to being poz is not a sprint, it's a marathon.

Many of us have been running for many years and we will be happy to help you both, however we can.

Welcome to the forums.

Joe 

[Robert]

If he's crying then it sounds more like a problem with depression than with the effectiveness of the drugs. You say he's on Atripla. From what I've heard Atripla does more harm than good when it comes to depression. He needs to talk to the Dr and switch drugs.

[Joe K]

If he's crying then it sounds more like a problem with depression than with the effectiveness of the drugs. You say he's on Atripla. From what I've heard Atripla does more harm than good when it comes to depression. He needs to talk to the Dr and switch drugs.

Robert makes an excellent post.  I missed that he was on Atripla.  It contains Sustiva, a drug known to increase mental health issues.  I would also suggest he ask his doctor to change his drug regime to get rid of the Sustiva.  There are many fine alternatives that will control his virus without the Sustiva.

Joe

[LadyMisty1207]

@Zach I'm holding up much better now after the initial shock subsided..@Joe K I read your post to him today and he felt a little better and @Robert I told him that he should talk to his doctor if he feeling a a little depressed..

[zach]

read back through your thread, i knew i remembered talking to you... did you ever go on truvada as prep? if so, hows that going for you?

[magneticlove]

I definitely feel for you and your boyfriend, Lady.  Even though common scientific knowledge would tell us that a CD4 of 1100 is AWESOME and the VL of 660 is so close to undetectable you can taste it, I can empathize with the feelings that could go along with the small blip.  I remember my boyfriend being undetectable and then another month the VL was like 26 (which by some tests is undetectable, but I think his lab has like 15 or 20 as the cutoff) and I was even worried.  Now I look back on that and realize I was being deeply paranoid.  I know that feeling of powerlessness when helping your partner deal with their feelings surrounding their HIV diagnosis......

I really don't have any great advice.  Its been said.  And just love him and hug him a whole bunch.  When my boyfriend struggles with his status, I make sure I remind him that I love him for him.  And I really do.  I hope things get better.  <3 <3

[LadyMisty1207]

@Zach I never got Truvada as prep because we both decided to wait on having sex until his first doctor's appt after his confirmation back in May. So now him learning from the doctor the numbers that he didn't want to hear I guess we will be waiting for a little longer. I asked him about it and he said he just want to make sure that he doesn't get me infected.

@magneticlove I tell him that I love him and that I am here for him no matter what. I keep trying to get him to go into some type of therapy to help him with adjusting to being positive cause I can see that he needs to talk to someone. Thanks for your reply.