High Cd8 levels.

[Nextdoor_guy]

hey guys, got the results after 6 months since started the Treatment.
the CD4 is kinda good, around 600, will get the Viral load in about 2 weeks and hope will be UD but there is a problem with CD8..
Even thought the Cd4 raised since the start of the treatment from 450 to 600, the CD8 levels are still very high, around 1300 and didn't dropped at all after 6 months.
I know many of you don't give too much importance to Cd8 values, but this is a sign of an inflammated immune system, and on long term this is bad for health..

So what do you think, should I ask my Dr to start and anti-inflammatory therapy, or just wait.....

[wolfter]

I've not had a cd8 count done in ages.  I was under the impression that it's not valuable any longer.  It'll be enteresting to see what others say.

[newt]

Nobody really knows it anti-inflammatory treatment is a good idea for high CD8 counts in HIV. Indeed nobody really knows if a high absolute CD8 count is a good or bad thing in the context of HIV. I's just assumed from other parts if medicine and a few small-scale bits of research that this equals inflammation which equals bad. This may be true but it might also, plausibly, be protective, or temporarily protective. Treatment may settle the count down in a while too.

- matt

edited for spelling

[tednlou2]

I've been reading a lot about how many think we need to shut down HIV's inflammatory response.  However, many were saying inflammation is a very important part of our immune system and shutting it down could actually cause more harm.  So it does make one wonder how much inflammation is good and how much is bad.  I know a high CD8 is believed to be a good thing--the body fighting off the effects of HIV or any virus.  But, I know many believe long-term inflammation may lead to things like lymphoma and other health problems. 

This was a study report I had bookmarked that talked about this issue.  I didn't save all the other studies I've read regarding this.

http://www.thebody.com/content/confs/aids2010/art57494.html

[eric48]

Hi,

to make a long story short. CD4 are your defense army scouts.
They switch on the alarm for infection and response
 Not enough of them and the army is of no help. this is immune depression

CD8 are cytotoxic. They are the cavalry, they are having a role in the actual killing of the infection.
They are an effective, executive part of your defense system.
Once they have been called on the front (of infection), they are meant to fight and stay for a while.

Hence CD4 and CD8 have different life cycles and life duration. They follow dynamics with different speed.

Since you are only 6 months into treatment, you should let things take their time

Cheers

Eric

[Nextdoor_guy]

Thanks for the replies guys.
Hope the things will settle down for me too..

[eric48]

Hi,

The key issues in immune system restauration is :

A - very few people had the CD4 and CD8 counted prior to infection
B - in the abscence of the above, one can only rely data collected on HIV neg, otherwise healthy individuals (standard range)
C - it would be nice, in terms of  immune system restauration, if the immune system would restore to its previous level (usually not known)
D - in the abscence of counts prior to infection, it would be nice if the immune system would restore to standard range
E- if CD4 count is over 500, CD4 % is a more relevant marker. CD8 count , as such, is usually not considered as a marker, but the CD4 to CD8 ratio is.

1- standard range differ from authors/scientists. Some mention CD4 700 as the lower end of the range in most HIV neg , otherwise healthy individuals
2- For Hiver, under HAART, key values for stratification are 500, 350, 200. They are of statistical relevance (the higher the better), but individuals experience may differ and some people are fine with a bit lesser values
3 - in most HIV neg , otherwise healthy individuals, the CD4 to CD8 ratio is usually between 1 and 2. In HIV, with no meds, this ratio is usually well below 1
4 - in the very elderly (age over 80),  HIV negs; a CD4 to CD8 ratio below 1 seems to be recently identified as a possible statistically relevant marker for fraility (immunosenescence). This is recent work (and everyone knows that science may require time before some concepts get firmly confirmed)
5 -  For Hiver, under HAART, it is a current open topic for research whether a CD4 to CD8 ratio below 1 is clinically or statistically or life expectancy relevant. May be yes, may be not
6 -  For Hiver, under HAART, as well as general population, it is not known how to intervienne and upmodulate to CD4 to CD8 ratio. It is also not confirmed whether it is important or not.

Some current research topics opened by a fairly small group of scientitist include identifying cause for  CD4 to CD8 ratio below 1 in otherwise successfull HAART patients.

While it is not 100 % confirmed the long term significance of a CD4 count below 500 (and needless to say not even a CD4 to CD8 ratio), it is statistically demonstrated, in one study, that men, not using drugs,
maintenaining undetectable VL and CD4 count over 500 for at least 3 years have a  statistical risk of death very similar to age matched general population (for males only, as of today).
other groups have an additonnal risk.

The additionnal risk (and therefore its mathematical incidence on life expectancy calculation by current life expectancy models) differs significantly in statistical analysis conducted in Europe and in the US.

Which proves that every thing of the above should be taken with a grain of salt and that speculation is not science...

Peace

Eric