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Author Topic: Stats and blood pressure  (Read 2815 times)

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Offline marriedmansam

  • Member
  • Posts: 45
Stats and blood pressure
« on: September 20, 2011, 02:38:26 am »
Hi Friends...

I think i am posting this for a little (more) reassurance and advice

My stats are included in my signature (below)

first question-

could someone explain the importance of the percentage related to the CD4 count? And how rapidly might this change?


My second question and concern -
Being fairly recently diagnosed i have taken great solace from looking at other members' stats to see the very effective impact of meds, such as Atripla. I understand the UK NHS guidance not to begin treatment until VL is over 100 000 or CD$ is below 350. But i have seen quite a number of forum members who had stats above this and then rapidly fell below the above benchmarks... sometimes over the space of two months.

My concern is that my Doc has already indicated that after my next visit (OCT)  he will not need to see me for a further three months.

While i understand that some people may not need meds for several years quite a few seem to progress from exposure to needings meds over the space of a few months.

Am I worrying unduly?

Blood pressure

As part of my initial appointment with my doctor he checked my blood pressure. He found this to be quite high. He pointed out the lower number (Diastolic?) was 104. I have always had BP readings that were fine previously.

I am not really a worried or a stresser. But for the last few weeks my diagnosis has consumed my thoughts! Could this in itself explain the BP reading?

I have an appointment with my GP practice to have my BP checked.


Many thanks in advance for all of your wise words.

Sam
June/July 2011- Infected
30 Aug 2011    - First test
31 Aug 2011     - Call to tell me first test was poz

3 Sept 2011       - Joined this forum
5 Sept 2011       - clinic appointment for retest
16 Sept 2011     VL 75 400 CD4 428 and 28%
next appointment  3 Jan 2012
3 Jan 2012          - VL 71 300 CD4 460 and 23%

Offline spacebarsux

  • Member
  • Posts: 1,350
  • Survival of the Fittest
Re: Stats and blood pressure
« Reply #1 on: September 20, 2011, 03:18:10 am »
Hey Sam, yep you are worrying a needlessly. Please do take some comfort in your very decent first lab numbers.

Here is some basic information for you off the i-base website. The lessons section on AIDSMeds also explains things quite well.

A CD4 count is sometimes called an absolute CD4 count, because it counts the actual number of cells in a blood sample. But a single CD4 count doesn’t tell you very much. You really need to get several results over time to see the trend.

CD4 counts fluctuate. They go up and down during the day. For example, CD4 counts are lower when you first wake up and higher later in the day. They are higher immediately after exercise – even running up and down stairs. They can also be affect by diet, whether you have other infections or even if there were just more or fewer cells in that sample of blood. None of these variations mean that your immune system is stronger or weaker.

This is why the trend of CD4 results is more important than any single count. The trend looks at the average of several results


CD4 percentage (CD4%)
The CD4 percentage (CD4%) is the percentage of white blood cells (lymphocytes) that are CD4 cells.

The immune system contains lots of different cells. The two main types of lymphocytes are T cells and B cells. CD4 cells are a type of T cell. So the CD4% looks at the CD4 count in relation to other immune cells.

CD4% is sometimes a more stable indication of whether there has been a change in the immune system. An unexpected drop in CD4 count when the percentage hasn’t changed indicates this drop is not clinically significant.

•A CD4% of 12-15% is about the same as a count of under 200 cells/mm3.
•A CD4% of 29% is about the same as a count of over 500 cells/mm3, but there is a wider range for higher values.
•An HIV-negative person has a CD4 percentage of about 40%


Link- http://i-base.info/ttfa/section-1/19-interpreting-cd4-results-cd4-count-and-cd4-percentage

So monitor your lab results every 3 months and you'll get a fair idea of how your body is fighting the infection. Once the time comes to start meds (as per your doctor's expertise and the guidelines in your area), you start and everything will be fine.

Best.
« Last Edit: September 20, 2011, 03:21:13 am by spacebarsux »
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline BM

  • Member
  • Posts: 340
Re: Stats and blood pressure
« Reply #2 on: September 20, 2011, 03:20:10 am »
The CD4 percentage is a more stable measurement of your immune status. Absolute CD4 can vary quite a lot depending on the time of day your blood is drawn and in response to infection or immunisation but the percentage will tend to be the same from one set of labs to the other. But what is more important than either is the trend over time of your labs. Is it stable or decreasing?

You might still be experiencing the initial huge viral load and drop in CD4 that follows recent (July) infection. If this is the case, you might see a reduced viral load and improved CD4 on your next visit.

Blood pressure can also vary quite a bit and is sensitive to stress (conscious or not). Don't sweat it yet.

The HIV care provision on the NHS is excellent. You are in good hands.

« Last Edit: September 20, 2011, 03:21:48 am by BM »

Offline buginme2

  • Member
  • Posts: 3,426
Re: Stats and blood pressure
« Reply #3 on: September 20, 2011, 03:36:27 am »
Hey,

Your stats were very similar to mine when I tested positive.  My cd4 was 410 at 36%, my viral load was lower than yours however at 13k.  My doc recommended starting treatment at that time (im not in the UK though, I'm in the US and the guidelines here recommend starting treatment once your cd4 falls below 500).  

I would not discount your high blood pressure.  I have high blood pressure also and I once asked my doctor if it was stress that was causing it.  He told me even If it is just stress causing your high blood pressure, so what? It's still high regardless of what's causing it and if it is high it's doing damage.  

I now take a very small blood pressure pill in addition to my HIV med. My bp is now under control.   A diastolic reading of 103 is very high.  In my opinion, being infected with HIV which increases your risk of heart, liver, and kidney disease I would take your no seriously.

Have a good one, and btw welcome!
« Last Edit: September 20, 2011, 03:39:08 am by buginme2 »
Don't be fancy, just get dancey

Offline spacebarsux

  • Member
  • Posts: 1,350
  • Survival of the Fittest
Re: Stats and blood pressure
« Reply #4 on: September 20, 2011, 03:58:05 am »

 My doc recommended starting treatment at that time (im not in the UK though, I'm in the US and the guidelines here recommend starting treatment once your cd4 falls below 500).  


Here is an extract of the US Treatment Guidelines Adults and Adolescents from the NIH website for your reference:

Based on these findings, combined with emerging biologic evidence regarding potential damage to end organs from inflammation associated with untreated HIV replication and the potential reduction in HIV transmission with treatment (see below), the Panel recommends initiation of ART in patients with CD4 counts between 350 and 500 cells/mm3. Panel members are divided on the strength of this recommendation: 55% voted for strong recommendation (A) and 45% voted for moderate recommendation (B) (A/B-II).


Patients with CD4 Count >500 Cells/mm


Based on these data, along with a better understanding of the pathogenesis of HIV infection and the growing awareness that untreated HIV infection increases the risk of many non-AIDS-defining diseases (see below), 50% of Panel members favor initiation of ART in HIV-infected persons with a CD4 count >500 cells/mm3 (BIII).

The other 50% of the Panel members are reluctant to broadly recommend starting ART at higher CD4 cell counts and consider that therapy should be optional at this stage of HIV disease (CIII). In making this recommendation, the Panel members note that the amount of data supporting initiation of therapy decreases as the CD4 count increases above 350–500 cells/mm3, and that concerns remain over the unknown overall benefit and long-term risks with earlier treatment.

When discussing starting ART at higher CD4 cell counts (>500 cells/mm3), clinicians should inform patients that data on the clinical benefit of starting treatment at such levels is not conclusive. There is a need for further ongoing research (both with randomized clinical trials and cohort studies) to assess the short- and long-term clinical and public health benefits and cost effectiveness of starting therapy at higher CD4 counts. Such research findings will provide guidance for future recommendations by the Panel.


Link:- http://aidsinfo.nih.gov/contentfiles/AdultandAdolescentGL.pdf
Infected-  2005 or early 2006; Diagnosed- Jan 28th, 2011; Feb '11- CD4 754 @34%, VL- 39K; July '11- CD4 907@26%,  VL-81K; Feb '12- CD4 713 @31%, VL- 41K, Nov '12- CD4- 827@31%

Offline newt

  • Member
  • Posts: 3,900
  • the one and original newt
Re: Stats and blood pressure
« Reply #5 on: September 20, 2011, 04:03:18 am »
High blood pressure needs treating regardless of cause, but beware of "office highs" ie it goes up in the doc's room cos you're nervous/stressing, two or three readings are helpful.

HIV itself may contribute to high blood pressure ins some cases.

Treatment in the UK is recommended solely on CD4 count, at around 350 unless you are having symptoms or have other conditions like a higher risk of heart disease, hepatitis coinfection etc, in which case the recommendation is start as soon as possible.

Tis true the time from diagnosis to treatment varies a lot, and this is really up to how your body reacts to HIV, no-one can say how long it will be.

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

 


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