What to expect from first lab results?

[dowellndoubtnot]

My bf is going to the doctor on tuesday to get his first lab results, and he is very nervous about it, so we are doing some research to try to prepare him for it.

While i of course understand that none of you can predict or should predict what these results will find, i have a couple questions that i would really appreciate if some of you could help answer for me.

My first question is...We suspect he has ARS about 2 and a half to 3 months ago, and had his lab work about 2 months at most after ARS. Would this increase the likelihood that his lab work will show he has a low CD4 count for this stage in HIV? I believe i have read on here that sometimes during and soon after ARS results sometimes come in with lower CD4 counts correct? If this is the case i want to inform my bf of this so that he does not freak out in case the number is lower than he is expecting. How long after ARS do CD4 numbers tend to bounce back up naturally?

My second question...if there was some really bad news in the lab results that needed quick treatment, would the clinic or doctor have contacted him immediately when the lab results came in informing him of this? He received a letter about 10 days ago from the clinic letting him know that the lab results were in and that he could go pick them up whenever he wanted to at the clinic, but he decided just to wait until his doctors appointment this tuesday to go in and get the results.If there was something urgent would they have contacted him and told him to come in right away? Once again, i know that you guys have no way of absolutely knowing the answer to this question about what this one specific clinic would do, but just general speaking any opinions would be appreciated

Lastly, i know these are things that he needs to talk about with his doctor, and things that he WILL talk about with his doctor on tuesday...we are just trying to prepare ourselves as much as possible for him going in.

Also, any other questions that we might not think of that he should be sure to ask the doctor on tuesday would also be very appreciated!!!

Thank you so much guys!

[Ann]

I've moved this thread and another one you started yesterday in the Living forum to the Someone I Care About forum as that is the more appropriate place for you to post unless you're asking specific questions about the meds, then posting in the Treatment forum is ok.



There's really know way of knowing what his labs might be like - they could be anywhere in early infection. His viral load may be very high (very typical in primary infection), or it might not be. His CD4s could be low, or they could be in normal ranges (above 500). How long is a piece of string?

Both VLs and CD4s tend to stabilise and go lower (VL) and higher (CD4) within a few months to a year after infection, but every one is individual and responds to hiv infection differently and so there's really no way to predict what will happen.

Regular lab work is the only thing that will tell you what's going on with any certainty - and none of us have crystal balls to figure out what labs will be before they come back.

Yes, if there was anything alarming in his lab work, they would have gotten him in sooner rather than later. If he's as newly infected as you seem to think, it's very unlikely that there will be any huge problems.

You would be wise to get a small notebook where you can write down any questions for the doctor - and leave space after each for the answer. It's too easy to forget what you wanted to ask, and forget what the answer was after you leave the office. Write it down.

[leatherman]

the most important thing to consider when thinking about lab results is that one test means very little. The only way to tell what the HIV is doing and/or how the meds are working is by the trend over at least three tests. while it can be very unnerving to have to wait weeks or months until another test or two has been taken, that's really the only way to know what's really going on and what direction to take.

Some of your questions are difficult to give you a definitive answer because it depends on when someone was infected, their genetics, and sometimes just how the HIV is working in their system. Everyone can be quite different, so there are only general guidelines to go back (until you have several tests to suggest what's going on). Often in the early days VL can be high and cd4s low as the virus sets in. It'll then lessen and go on for quite some time (like 2-10 yrs perhaps) before meds are needed. Like this chart shows:


also of note is that cd4 counts can change by up to 100 points in just one day (with the lowest counts in the morning hrs and the highest in the early evening). so the cd4 count can come back radically different every time - but if it's within 100pts or so it means nothing really changed.

as your BF is newly diagnosed and y'all are learning about this, definitely take the time to read through the Lessons section here at AM (http://www.aidsmeds.com/articles/Introduction_4702.shtml). You might want to start with the test section at http://www.aidsmeds.com/articles/BloodTest_5030.shtml

i would also suggest that unless you BF is in the hospital experiencing some AIDS/HIV related problem, then going on meds immediately is not something to worry about - at least not until a couple test results come back to show that he has a cd4 under 500 and closer to 350 with a high viral load amount as those counts or already having AIDS-related complications are the criteria for starting meds.

[leatherman]

You would be wise to get a small notebook where you can write down any questions for the doctor - and leave space after each for the answer. It's too easy to forget what you wanted to ask, and forget what the answer was after you leave the office. Write it down.

I was proofing my reply while Ann was posting, so I went ahead and posted even though we said a lot of the same things. Kudos to Ann for suggesting writing down questions. Not only does this help you two remember what you have questions about; but it shows/implies to the doctor that y'all are concerned and care about taking care of this HIV.

I always, 20+ yrs later, go to every doc. appt. with my paper lisst of questions and the last counts written down. I write down any answers I get and the newest results - so I know how my health is.

[dowellndoubtnot]

Thank you both very much for your answers and your help! It is greatly appreciated

I will update you on Tuesday!

[dowellndoubtnot]

We got his lab results yesterday.

He thankfully has no resistance to any drugs, or any other complicating factors.

His CD4 count was 490 and his VL was 4000.

He is going to his case worker next week to get enrolled in Altripla.

Overall i think the lab results came back great from what i have learned over the past few months, but i'd love to hear feedback from some of you guys.

Thank you!

[dowellndoubtnot]

Just wanted to update everyone because you were all such a great help back when all this was going on.

My bf just got his 3rd lab results back today after being on Atripla, and he is still UD (has been since the first lab results after being on it), and his CD4 is up to 650, has progressively slowly gone up, so all great news!

[Jeff G]

Just wanted to update everyone because you were all such a great help back when all this was going on.

My bf just got his 3rd lab results back today after being on Atripla, and he is still UD (has been since the first lab results after being on it), and his CD4 is up to 650, has progressively slowly gone up, so all great news!

Excellent ! , no matter how many times I hear somebody's meds are working it brings a tear to my eye . Its just medicine for some folks but there are times when those pills still seem like a miracle to me . 

[dowellndoubtnot]

Thanks Jeff!

And I totally know what you mean! Sometimes my partner and myself just can't help but step back and be amazed at how lucky he is to be living in this time with the medications out there...and how lucky he is that he is responding so well to them, because we know sometimes it does not work out that way!