viral load

[nmranger]

so when i got my first labs on 09/10 my CD4 was 183 / 13.1% and VL  5690 on 10/4/10 is when i first started taking Atripla. Then i got my second set of numbers which were in early 11/10 were CD4 206 and VL in the 800's. In early December i got another set of numbers and my CD4 is now 249 / 17.8% and VL is 200.

my question to you all is, is this normal? like i notice some people go from having a VL in the 100k+ and then go undetectable.  I do like that my CD4 is going up however it seems to be as well as my doctor that the VL isn't becoming undetectable as fast as he'd and well I'd like it too.  They did a resistance test and so far the virus hasn't mutated so the doc said all the meds should work. 

What ya'll think?

[zach]

bet you're undetectable in a couple months 

[surf18]

sounds like your on track. my cd since dx/meds in july was like 225 and now six monts later its 407 % went from 12 to 22
vl ud since i think october.so yep your on track

[phildinftlaudy]

Hey Ranger -
I think that if you are tolerating the Atripla well and seeing increases in your CD4 and CD4%, as well as decrease (although slower then you would like) in VL, you should stick with it for at least the next few months.  My VL wasn't all that high when I went on Atripla and it still took a little time for it to drop to "UD."

So, my 2 cents - for what it is worth - is to stay the course for at least one or two more draws and see how it plays out.

[nmranger]

great thanks for the replies .....


i do plan to stick with it .... i really do like atripla and sticking to the 1-pill a day ... so hopefully i'll be UD on my next draw next week...

*Crosses Fingers*

[metekrop]

Your numbers are confusing for me.  How come you are negative in 12/09 and test positive after a year in 8/10 with only CD 183 and VL of 5690?  Is that CD number is too low when a person get tested positive for the first time?

[Ann]

Your numbers are confusing for me.  How come you are negative in 12/09 and test positive after a year in 8/10 with only CD 183 and VL of 5690?  Is that CD number is too low when a person get tested positive for the first time?

Some people just progress faster than others. It could also be that his immune system hadn't yet recovered from the initial infection. It might be that his VL had only recently dropped and his CD4s were still in the process of going back up. It is not unusual for a newly infected person to have a high VL and low CD4s in the first six months to a year before the immune system gets to grip with the new resident.

[nmranger]

Your numbers are confusing for me.  How come you are negative in 12/09 and test positive after a year in 8/10 with only CD 183 and VL of 5690?  Is that CD number is too low when a person get tested positive for the first time?

That's something that's confused both me and my doctor he thinks that I might have a aggressive strain or he says that the test in dec,09 was a false negative. 

[tednlou2]

That's something that's confused both me and my doctor he thinks that I might have a aggressive strain or he says that the test in dec,09 was a false negative. 

As Ann said, I thought this was fairly common to have high VL and low CD4 soon after infection.  Correct me if I'm wrong, but I've read where someone could have a CD4 very low after infection but their immune system still be in pretty good shape.  Basically, someone right after infection with a CD4 of 200 is not the same as someone who has been poz for many years with the same CD4--someone just infected with low CD4 still had a very intact immune system and that CD4 200 was not an accurate picture of the immune system of someone just infected.  If this is correct, this is why I've always wondered why many docs freak out when someone has these numbers within 2 months of infection and their docs want to start them on meds right away.  If this is incorrect, please advise.       

[surf18]

when i was dx'd i had cd of 227 and vl of 16000. so really a low cd and pretty low vl. dr thought i had this for 2 years.
i was very surprised how low my cd was in such a short time. started meds the next day.

[Maelrod]

It's confused cuz happen to me, 2009 november to be specific was  my unprotected sex and in the summer of same year was neg.  So in august 2010 was poz w 279 cd4 and 122k vl never been sick

[Ann]

As Ann said, I thought this was fairly common to have high VL and low CD4 soon after infection.  Correct me if I'm wrong, but I've read where someone could have a CD4 very low after infection but their immune system still be in pretty good shape.  Basically, someone right after infection with a CD4 of 200 is not the same as someone who has been poz for many years with the same CD4--someone just infected with low CD4 still had a very intact immune system and that CD4 200 was not an accurate picture of the immune system of someone just infected.  If this is correct, this is why I've always wondered why many docs freak out when someone has these numbers within 2 months of infection and their docs want to start them on meds right away.  If this is incorrect, please advise.       

I've always wondered too why some docs freak out when someone has poor numbers only a few months into their infection. There can be many reasons for this, as I mentioned earlier. Another possible reason is that the person just had naturally low CD4s to begin with.

It is rare for someone to have a base-line CD4 count from before infection, but it is known that not everyone has high CD4s while hiv negative. Remember, 500 (to 1200 or so) is considered to be a "normal" count in someone not infected. If a negative person normally has CD4s in the 5/600 range, it's a no-brainer to see how they could easily have numbers under 200 when newly infected and the VL is sky-high.

Dunno. Maybe the doctors who freak out are ones who prefer to err on the side of caution and assume that the person is having a very poor response to the virus or that they have a virulent strain and act accordingly.

[nmranger]

when i was dx'd i had cd of 227 and vl of 16000. so really a low cd and pretty low vl. dr thought i had this for 2 years.
i was very surprised how low my cd was in such a short time. started meds the next day.

That's what my Dr thought too that i could've had it for 2 yrs since I had a really low vl.  Which I guess would make sense because I was with my partner from June 08 - June 09.  We lost communication so i can't nor do I wish to confront him.

[nmranger]

I've always wondered too why some docs freak out when someone has poor numbers only a few months into their infection. There can be many reasons for this, as I mentioned earlier. Another possible reason is that the person just had naturally low CD4s to begin with.

It is rare for someone to have a base-line CD4 count from before infection, but it is known that not everyone has high CD4s while hiv negative. Remember, 500 (to 1200 or so) is considered to be a "normal" count in someone not infected. If a negative person normally has CD4s in the 5/600 range, it's a no-brainer to see how they could easily have numbers under 200 when newly infected and the VL is sky-high.

Dunno. Maybe the doctors who freak out are ones who prefer to err on the side of caution and assume that the person is having a very poor response to the virus or that they have a virulent strain and act accordingly.

I agree with maybe some peoples cd are already low to begin with which is why they'd go under 200 faster.   However how do u think my situation happened that I had a low cd and low vl.  Does that happen ?     

[Ann]

I agree with maybe some peoples cd are already low to begin with which is why they'd go under 200 faster.   However how do u think my situation happened that I had a low cd and low vl.  Does that happen ?     

It could be that although your immune system had gotten your virus under a semblance of control, your CD4s simply had not had enough time to fully recover. You need to remember that even people who have become undetectable on meds can take some time to rebuild their stock of CD4s.

[nmranger]

It could be that although your immune system had gotten your virus under a semblance of control, your CD4s simply had not had enough time to fully recover. You need to remember that even people who have become undetectable on meds can take some time to rebuild their stock of CD4s.

Gotcha.  Thanks Ann for the fast response