Cd4 plateau?

[markdown]

I have mentioned before in another thread that I am in a Phase III study of the quad pill. I just got back my 4 month results: viral load undetectable (as it has been since the first month) and Cd4 at 375. Between month one and two, my Cd4 went from 214 to 359. Now, two months later, it's only risen 16 points. I'm not sure of the percentage.  Is this a normal reaction : to plateau for awhile? Don't get me wrong, I'm very happy with the results, I was just hoping that I would get another dramatic increase.

[Tempeboy]

Hey Markdown,

Recent research suggests that once you commence treatment your CD4's continue to increase on average for seven years - at varying rates.

Remember that your CD4 count goes up and down all the time, it's higher in the morning that the evening, your count responds to other infections, stress, fatigue, poor nutrition, cigarettes, STI's etc - so it is important to look at your trends over time - and in just 4 months your CD4's have continued to go up and up, and have increased by 43%!!!!!

Sometimes in the first few months of treatment, once your immune system begins to return to normal function it will respond to 'infections' that it has not be 'strong' enough to deal with previously - your results could indicate that your immune system is cranking beautifully.

The important things to focus on are that your meds are working, you are taking great meds, your viral load is undetectable and your CD4's are going up.

Healthy living, stress management, adherence and posiitive thinking will help.

[markdown]

Thanks for the words of encouragement Tempeboy. I feel lucky to have done so well so quickly.

[eric48]

once you are under powerfull meds that work for you (which is obviously the case, since you are UDs), viral replication stops or is negligible

After a sharp decrease, there is a second phase of decay where the system needs to purge remaining, already (previous to meds) infected CD4s.

these are killed by inflammation (CD8, mostly), since you when UD fast the most likely reason is that inflammation was high (many CD8 compared to few CD4)

Until they, themselves die (by their natural life span), your CD8s are still around, and they keep killing CD4s.

This remaining inflammation is a limiting factor to the ex pension of CD4s.

CD8s have a longerlife time than CD4. it will take CD8s and therefore inflammation, quite a while to decrease.

Its like running a car with the hand break on. It speeds up , but not as fast as one would hope.

But eventually, that inflammation will wear off as well and then the car will run freely.

Anything that turns on or maintains inflammation at a higher level also reduces your chances for higher CD4s. and these include:
- smoking
- other STDs (so safer sex is still required)

A healthy colon, where inflammation controlling bacteria dwell, would be a plus. A very diversified diet should help

At least, this is the way I look at it... And I hope this helps

Eric

[markdown]

That was  a clear and concise explanation Eric48. I appreciate your time in explaining this to me. Two nights ago I had an extreme case of the night sweats--my bed was soaked. Would the inflammation you mentioned cause this?

[Gio]

Eric - so how long is the decay

[eric48]

my bed was soaked. Would the inflammation you mentioned cause this?

Hi,

My doc asked me several times if I have had night soaks events (which I have not). I would therefore recommend that you mention it to your doc on your next visit.

The 'inflammation' term, as used in my above post, refers to an activation state of the immune system. The word itself carries a 'heat' symbolism, but,  would not know if what you have experienced is caused by the biological process. I think the medical term comes from common observation that body heats up when its is reacting to a viral infection (such as the flue)

As for the question how long does that decay takes, if you would allow me, I will refrain from giving a definite answer since I am currently researching a lot into this (complex) matter.
The decay (in CD4) is the reason why it takes some time for one to become UD.
in some some people, it only takes a few weeks, in some others it may take longer.
If it takes too long, then it may mean that the meds are not working on your virus (and a switch is required)
That concept of 'it takes too long' is understood differently by the various docs and guidelines.

The decay in CD8, is a related but different concept. in some people (myself) it goes down steadily and I think contributes to me feeling 'healthier' (despite not being UD, yet). In some other people , who are otherwise UD and have a good CD4 recovery , this excess of CD8 may last long, if not for ever, and, could be (merely a hunch of mine more than solid proven fact, at this time) the reason why some HIVers suffer from what they call inflamm-aging

Because decrease of viral replication and recovery in CD4 numbers is so much more vital to your body than this de-inflammation, they have been studied and theorized in depth.

CD4s and CD8s are inter related but have a life (and life cycle) of their own. during the time you let viral replication in you blood, the interaction between CD4 and CD8 is high, then, once the viral replication stops (if you are under successfull medication), they kind of go back to their own business-as-usual life.

Which is why the dynamics of the complete system is so complex and the issue initially posted by markdown is, in my humble opinion, not alarming. Patience (and I would dare add, a as-healthy-as-you-can lifestyle) should help.

Cheers

Eric