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Author Topic: A Blip or Something More  (Read 5149 times)

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Offline bmancanfly

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A Blip or Something More
« on: December 09, 2010, 02:49:14 pm »
My lates labs came back kind of disappointing. 

My VL which has been UD for 3 years came back at 1237.   Ironically my CD4 was 532 and a % of 33,  which is much higher on both counts than ever before.  It almost feels like I got someone else's blood work back,  even though I know that's not possible.  Anyway, this VL seems way too high to just be a blip.

I haven't missed a single dose in three years and have always been <50 on every test.  My doc asked me three different times if I had missed any doses or had unprotected sex with anyone - none of which had happened. 

I feel like I'm just getting over last months KS scare and now this.  I'm worn out.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline Miss Philicia

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Re: A Blip or Something More
« Reply #1 on: December 09, 2010, 02:52:20 pm »
Hey bman.  Does seem high for a blip though I suppose anything is possible.  I've had two blips and they were both ~100 and I think that's a more normal number.  Did your doctor not recommend immediately retesting to rule out a lab error, and then if it's still elevated of course getting a geno/phenotype test?
"I’ve slept with enough men to know that I’m not gay"

Offline newt

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Re: A Blip or Something More
« Reply #2 on: December 09, 2010, 03:25:45 pm »
Quote
It almost feels like I got someone else's blood work back,  even though I know that's not possible.

This happened to me...

Up to 2,000-2,500 is reasonable margin for considering a one-off viral load test result over 50 to be a blip.

Naturally, as a good clinic, they did a retest straight away, right?

- matt
"The object is to be a well patient, not a good patient"

Offline bmancanfly

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Re: A Blip or Something More
« Reply #3 on: December 09, 2010, 04:25:50 pm »
Thanks Philly and Newt for your replies.

I did go have another blood draw done after I got these results today.  One for VL and if there is a high enough VL they will do a genotype.   

"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline bmancanfly

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Re: A Blip or Something More
« Reply #4 on: December 10, 2010, 10:12:32 am »
When I was filing away my recent labs paperwork I found a medical receipt that I had forgotten about.  On Nov. 24 I stepped on a rusty nail and went to go get a tetanus shot.  The wound was pretty deep but did not,  by all appearances,  get infected.   I had my blood drawn on Nov 30 for the blood work that came back with the 1237 VL.

I may be grasping at straws,  but could a tetanus shot have caused my VL increase?
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline natthai

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Re: A Blip or Something More
« Reply #5 on: December 10, 2010, 05:29:31 pm »
When I was filing away my recent labs paperwork I found a medical receipt that I had forgotten about.  On Nov. 24 I stepped on a rusty nail and went to go get a tetanus shot.  The wound was pretty deep but did not,  by all appearances,  get infected.   I had my blood drawn on Nov 30 for the blood work that came back with the 1237 VL.

I may be grasping at straws,  but could a tetanus shot have caused my VL increase?
Thats very interesting you mention that. I tested positive after a huge motorcycle accident in which I was the passenger and fell down the side of a mountain. Unfortunately I was on a very remote island in Thailand at the time. There was no hospital within several hours of me. I had to wait 2 hours to get a ferry boat off the island and other 1 hour in a taxi before getting arriving at a big city with a hospital. All time time I was bleading profousely with skin and muscle torn and hanging off of my arm, legs and face all mixed together with dirt and gravel. When I got the the hospital the Doctor asked my 3 times if I had recently had a tenanus booster. I said I couldn't remember and he gave me one (Tetanus toxoid). Later on I found out that I did indeed have one 2 years before and that I shouldn't have that shot at that time. Two or three weeks later I tested positive. That incident was a pretty big shock to my system and I always wondered what affect it had on me. Anyway, that was NOT a good month...
« Last Edit: December 10, 2010, 05:58:57 pm by natthai »
Infection date: February 14, 2010 (yeah really)
08/03/2010 - CD4 621 (27%) VL 72,250
25/03/2010 - CD4 981 (28%) VL 122,719 <-started anti-oxidants (ABCDE, Se, ALA, NAC)
11/08/2010 - CD4 1,365 (31%) VL 5,451

Offline veritas

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Re: A Blip or Something More
« Reply #6 on: December 10, 2010, 06:07:21 pm »
When I was filing away my recent labs paperwork I found a medical receipt that I had forgotten about.  On Nov. 24 I stepped on a rusty nail and went to go get a tetanus shot.  The wound was pretty deep but did not,  by all appearances,  get infected.   I had my blood drawn on Nov 30 for the blood work that came back with the 1237 VL.

I may be grasping at straws,  but could a tetanus shot have caused my VL increase?

bman,

Yes, it's possible. See this:

http://www3.hants.gov.uk/adult-services/hiv/hiv-living-with/hiv-vaccinations.htm


Another test should sort it out.

v

Offline bmancanfly

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Re: A Blip or Something More
« Reply #7 on: December 21, 2010, 05:20:56 pm »
I had another blood draw on 12/9 and the VL rusults were 129.  I'm happy that it went down but concerned that I'm still not UD.  They drew blood for a genotype test (no results yet) but I would imagine that with a VL of only 129 they won't be able to do a genotype.

My next blood draw isn't scheduled for another three months.  That seems like a long time to wait if my VL is not UD.

I'd appreciate any suggestions on what I should do now.
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline Assurbanipal

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Re: A Blip or Something More
« Reply #8 on: December 21, 2010, 05:30:07 pm »
Two tests above 50 in a row is, by definition, not a blip.  

Of course, a viral load of 129 is certainly not anything to panic over and you do have this issue of the nail you stepped on that could be a possible explanation.

But, still, it would seem appropriate to monitor more frequently than every three months.  Why not follow up with the clinic to see if the genotype worked and to schedule a new test?

5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline bmancanfly

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Re: A Blip or Something More
« Reply #9 on: December 23, 2010, 02:23:53 pm »
My understanding is that a genotype can't reliably be done with a VL below 1000.   So that's not going to work.

My concern is now is I'm on a cocktail where all of the components may not be working,  which is increasing my chances for resistance.  Should I stop taking what I'm on?

My doctor is gone until the begininng of January and the nurses don't know how to,  or want to,  answer my questions.

I'm concerned but not sure what to do.  I hate to just wait,  especially if waiting is potentially making the situation worse. 
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline newt

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Re: A Blip or Something More
« Reply #10 on: December 24, 2010, 04:49:23 am »
I'd be happy with 129. A few weeks isn't going to make any difference resistance wise with that level of virus.

A genotype can be done fairly well with a viral load of about 400-500, even though the test makers don't officially say so.

Better to stay on the meds til Jan, I think personally. I don't know what combo you're on, but if it's the efavirenz/FTC/tenofovir one that comes as Atripla, then stopping short term is deffo a bad idea. When you stop efavirenz you generally replace it with a PI/continue on FTC/tenofovir (Truvada) for 2-3 weeks to prevent resistance as efavirenz takes a long time to leave the body completely.

Have a good Christmas

- matt
"The object is to be a well patient, not a good patient"

Offline bmancanfly

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Re: A Blip or Something More
« Reply #11 on: January 21, 2011, 08:34:40 pm »
Jan. 15 labs showed back to UD

Must have been the tetanus vaccination.   ;D
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline eric48

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Re: A Blip or Something More
« Reply #12 on: January 21, 2011, 09:12:24 pm »
Yep...

same as with the flue vaccine... My doc said that while under VL monitoring, do the blood draw first and then the vaccine

He said vaccines screw (up) VL

Eric
NVP/ABC/3TC/... UD ; CD4 > 900; CD4/CD8 ~ 1.5   stock : 6 months (2013: FOTO= 5d. ON 2d. OFF ; 2014: Clin. Trial NCT02157311 = 4days ON, 3days OFF ; 2015: https://clinicaltrials.gov/ct2/show/NCT02157311 ; 2016: use of granted patent US9101633, 3 days ON, 4days OFF; 2017: added TDF, so NVP/TDF/ABC/3TC, once weekly

Offline hope4love

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Re: A Blip or Something More
« Reply #13 on: January 26, 2013, 06:27:25 am »
I had my blood work yesterday. The results are not impressive and I was not expecting this to happen. My I have first blip in two years, VL is 72 IU/ml, I was UD six months back, My CD4 is also reduced from 600 to 493. My cholesterol level which was normal six months back has risen, Total Cholesterol at 202 mg/dl, Triglycerides at 183 mg/dl, LDL cholesterol at 139 mg dl.  I have not missed a dose, couple of times I have taken medication few hours late.This is causing discomfort & bothering me. I will be meeting my Doctor soon with the reports. Not sure what he plans to advise.
Jan 2009 - Sero Negative
Jan 2010 - Sero Positive
               CD4 - 275, VL - 18,000
Oct 2010 - CD4 - 241, Started - Vonavir; Oct 2011 - CD4 - 474;Jan 2012 - CD4-620; Aug 2012-CD4-600, VL- UD; Jan 2013 CD4-493, VL-72 IU/ml   (Blip)

Offline mikeyb39

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Re: A Blip or Something More
« Reply #14 on: January 26, 2013, 09:49:43 am »
i'm not sure why the doctor would ask you if you had unprotected sex.  Why would that increase your VL.   
11/02/2010  cd4-251, vl-591000
12/09/2010  started Atripla
02/18/2011  cd4-425, vl-800
06/10/2011  cd4-447, vl-70
10/10/2011  cd4-666, vl-80
01/05/2012  swiched med (prezista,norvir ,isentress, )
02/10/2012  cd4-733, vl-UD  Viread removed
06/10/2012  cd4-614, vl-UD
12/14/2012  cd4-764, vl-UD
09/01/2013  cd4-785, vl-UD
03/06/2014. cd4- 1078, VL-UD
09/05/2014  cd4-850 , VL-UD
09/05/2014 switched meds isentress, prezcobix -still only two antivirals
10/14/2015  cd4-600 , VL-UD

Offline texaninnyc87

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Re: A Blip or Something More
« Reply #15 on: January 26, 2013, 12:47:21 pm »
You could, theoretically, maybe, get "re-infected" with another strain that might be resistant to your current meds. I imagine this is why the doc asked about unprotected sex.
Dxd: 9/11/12
Blot confirmed: 11/12
12/12 cd4: 280 (20%) vl: 129,000
1/13 $tribild
2/13 cd4: 350 (26%) vl: 80
4/13 cd4: 510 (29%) vl:: 35
6/13cd4 350 (31%) vl: 21
9/13 cd4 492 (30%) vl: ud
12/13 cd4 846 (36%) vl: 100
1/14 cd4 480 (31%) vl: UD
3/14 cd4 650 (33%) vl: UD
6/14 cd4 410 (35%) vl: UD
9/14 cd4 439 (38%) vl: UD
12/14 cd4 551 (37%) vl: UD

Offline bmancanfly

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Re: A Blip or Something More
« Reply #16 on: January 26, 2013, 01:31:40 pm »
I think there is some confusion here.

Hope4love posted to a thread that I started a long time ago. 

Hope4love,  not that I mind you posting your question here,  but it is usually best to start a new thread .   Less confusing that way.

To your question,  discuss this with your doc,  but I wouldn't worry about such a low viral load.  The the difference in CD4 also is not so significant.

My "blip" resolved inself in a few weeks.  Mine was probably caused by a tetnus vaccination.

I know it is hard but try not to worry too much. 
"The trouble with the world is that the stupid are cocksure and the intelligent are full of doubt."

 Bertrand Russell

Offline hope4love

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Re: A Blip or Something More
« Reply #17 on: January 26, 2013, 02:02:31 pm »
thanks Bman for your reassurance. I Will be consulting my doctor soon. Hope its not going to be concern.
Jan 2009 - Sero Negative
Jan 2010 - Sero Positive
               CD4 - 275, VL - 18,000
Oct 2010 - CD4 - 241, Started - Vonavir; Oct 2011 - CD4 - 474;Jan 2012 - CD4-620; Aug 2012-CD4-600, VL- UD; Jan 2013 CD4-493, VL-72 IU/ml   (Blip)

 


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