Update on switch to Dovato from Biktarvy

[Dogman]

Good morning, I would like to give an update on my recent switch from Biktarvy to Dovato.

I have been on Dovato now for a month, after being on Biktarvy for 9 months (initial treatment).

my VL stayed UD, my CD4's however dropped from 470 down to 400, and my CD4/CD8 % dropped from 17% to 14%. I have had a cold for about 1.5 weeks, which I'm hoping is the reason for the downtown in CD4's

Otherwise, the switch was without side-effects. I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).

I hope everyone is doing well

[Jim Allen]

I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise?


Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.

Are worried about CD4 counts and if so why?

[Dogman]

I'm glad to hear you are doing well with the new treatment. How are you feeling/doing otherwise?

Apart from a cold, I feel just fine physically, I struggle big time mentally, which is slowly going away.

Not sure, are you expecting a change in HIV meds would somehow change your CD4 count? CD4 count will vary by even 100 points within a day, I could sneeze between tests, and the two tests would have a different count, All HIV meds do is suppress the virus; they don't change your CD4 counts, and to be honest, you should not even be looking at CD4 counts anymore.

No, I didn't expect anything CD4 wise from the new med, I'm happy i'm still UD. I have read many posts on CD4 count and while I was hoping for an increase, simply because they haven't gone up in 6 months, I'm not panicking about it.

Are worried about CD4 counts and if so why?

I am not particularly, I would like them to be in the "normal" range, but I guess that will come with time and patience.

Thanks for replying, hope you're doing good too!

[leatherman]

I was hoping to have a CD4 of > 500 after nearly 12 months of treatment (initial CD4 was around 175).

ugh. this is one of those wrong "hopes" I wish doctors would explain better.

ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.

Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.

Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.

Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.

cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves.

[Dogman]

ugh. this is one of those wrong "hopes" I wish doctors would explain better.

ARVs sole purpose is to interrupt, at several different points, the life cycle of the HIV virus. The effect is that HIV is reduced, although sometimes it takes times, to undetectable. Once that happens, and as long as you remain undetectable, your body has the chance to replenish cd4s. Now how fast that happens is all up to the genetics that created your immune system. Some people rebound fast. Some don't. Some people have a "low" rebound. Some jump above 1000. So really the most important number to look at is the VL. As long as that remains low, HIV is unable to do much, if any, further damage to your body.

I do understand this, I was just being hopeful that my CD4 rebounded rather than went backwards. But yes, apart from a pesky cold in the past week, I have felt perfectly normally physically.

Of course, a lot of people end up caring about the cd4 number; but why? First, there's a huge number range of what is defined as "normal". The limits tend to be a little hazy too. is 400 or 500 the lower parameter? Is 1200 or 1600 a normal upper parameter? Then there's the pesky problem that the cd4 count is only a quantitative amount. The test can't determine the strength of those cd4s (a qualitative description). While most people need that average range of cd4s (400-1600), there are plenty of people who live healthy lives with cd4s in the 250-400 ranges.

Last, but not least, since cd4s can change by up to 100 points in one day, it's kind of hard to get anything other than a snapshot of the cd4 count at blood draw. That 400 result that you received could have easily been 300 or 500 on that same day. Sounds extreme, right? But if you did 4 cd4 tests in one day, you could quit easily see results all over that range.

Not to bore you with my 40yrs of living with HIV, let me tell you the short story of why worrying about cd4s is useless. My first test was a miniscule 5 cd4s. Ten years and a dozen regimens later, I was lucky to have a whopping 225. Another 15 yrs after that I was up to 350. In that 25 yrs I hadn't returned to the hospital, had two bouts of flu and about 4 colds. Quite frankly, since the last time I was hospitalized with AIDS (30ish yrs ago) and got onto newer meds, I've been getting healthier and healthier. Oddly enough, in the last 3 yrs, my cd4s have jumped to 650, and the only sickness I've had in yrs was covid 2 yrs ago. For a long time, I was like you hoping to reach the "normal" range, until I realized that it didn't matter. Keeping medicated to stay UD was all it took. It may have taken nearly 30 yrs to get into the normal range; but when I did, nothing changed. I was just as healthy and happy as I had always been.

Please, never apologize, you do not bore me. I have read your posts over and over. I regard guys like you very highly, I have a couple of friends, who like you, went through the wars and are like you, still here, healthy and happy. I know we have it "easy", with the modern medicines etc.

cd4 results are just a number, like blood pressure, that's too in flux to mean much - well, as long as they are above 200. Worry about keeping your viral load undetectable, and your cd4s will take care of themselves.

Thank you, my doctor doesn't want to see me for 3 months, and yes, he also stated being UD is what to focus on. So thank you again, for your insight and reality check, I don't mean to sound like a whiney baby - it's just a struggle at times, I appreciate you and your valuable wisdom and experience.

[leatherman]

it's just a struggle at times

ain't that the truth? A big ol' truth about living with HIV. You're not whiney. You're just rightly concerned about your health - and it's just a struggle at times.

Hell. As much as HIV doesn't impact my life these days (a couple pills in the morning, a couple with dinner), this weekend while talking with my husband, our conversation slipped to the past. Right in the middle of a story about my bad times with HIV that I've told a million times (I've done a lot of speaking and advocacy work, so I've told my story a bunch), suddenly tears. Twenty-five years removed from being in the hospital struggling with HIV and there I was still struggling. 

I'm not saying most of my days aren't great, because they certainly are ; but no matter the happy talk, we (all of us living with HIV) get you and know even in the best of times, sometimes living with HIV is just a struggle.

your valuable wisdom and experience.

wisdom? I don't know about that. LOL I know a lot about some stuff that's all.

experience? ugh! too damn much. LOL All that "experience" just means I'm old now. ROFLMAO Even though I try not to ever act my age, having been in a hospital really close to dying on two different birthdays, I'm always been darn happy about getting older. It sure beats the alternative, even if it means I'm stuck with "wisdom" and "experience".

[Dogman]

ain't that the truth? A big ol' truth about living with HIV. You're not whiney. You're just rightly concerned about your health - and it's just a struggle at times.

To be honest, my health is pretty good, I have high BP which is managed, but hell I'm 60's. My struggle is the constant referenced to "diseased" in my doctor's reports. He often refers to AIDS - technically I don't have AIDS, I have the virus that causes it - and I'm being pedantic and in a form of denial, but being labelled as diseased, when I feel perfectly fine, good appetite, normal energy - really does my head in after every visit.

Hell. As much as HIV doesn't impact my life these days (a couple pills in the morning, a couple with dinner), this weekend while talking with my husband, our conversation slipped to the past. Right in the middle of a story about my bad times with HIV that I've told a million times (I've done a lot of speaking and advocacy work, so I've told my story a bunch), suddenly tears. Twenty-five years removed from being in the hospital struggling with HIV and there I was still struggling. 

Given what you ( and some people I know ), have been through moves me to tears, because I have not had to (and hope I don't) - I don't have anything to complain about, but it comes down to relevancy, and this is my reality, but I take your words on board. Hell a friend of mine, her  son just had his leg amputated because of diabetes, another friend is dying of bowel cancer. In perspective, so far, I'm doing ok. Can you see how I'm just verbally convincing myself here, but it is the truth.

I'm not saying most of my days aren't great, because they certainly are ; but no matter the happy talk, we (all of us living with HIV) get you and know even in the best of times, sometimes living with HIV is just a struggle.

Wisdom? I don't know about that. LOL I know a lot about some stuff that's all.

I think one of my things is, I'm not sure why it's a struggle. It's well managed, it's a virus. Everyone has virus' in them, yes it's a particularly nasty virus when not controlled, so I think a lot of my struggle comes back to the "diseased" label that I see on every correspondence from my doctor.

experience? ugh! too damn much. LOL All that "experience" just means I'm old now. ROFLMAO Even though I try not to ever act my age, having been in a hospital really close to dying on two different birthdays, I'm always been darn happy about getting older. It sure beats the alternative, even if it means I'm stuck with "wisdom" and "experience".

Getting old sucks, but the alternative sucks more. Again, thank you for putting things into perspective. I don't have a good support system (my own fault), and haven't discussed my situation with anyone but my doctor and one other member on here. I don't mean to rant, I'm just expressing to someone who's willing to listen and respond, for which I am honestly, extremely thankful for. :-)

[Tonny2]

               ojo.           Hello there!… i’m sorry that you are struggling with this term “disease “. To tell you the truth after 29 years I living with this condition, my doctor has never has mentioned the world disease, although, my card, theologist, he says that I have heart disease after putting a stem in one of my veins, which I don’t like it because I feel fine, but it is what it is… like you said, there are people who have it worse , like those friends you mentioned… about renting, we are here for you, don’t worry about it…hugs

[Tonny2]

         ojo.       * cardiologist… sorry for the typos…I’ve lived for almost 29 years with hiv and, I don’t recall ever shedding a tear for my condition not even when I started to lose my vision, maybe I need a good cry, it would help with my eye dry condition, but again, we all are different…wishing you the best dogman and don’t forget that we are here for you…hugs from Ohio, USA

[Dogman]

         ojo.       * cardiologist… sorry for the typos…I’ve lived for almost 29 years with hiv and, I don’t recall ever shedding a tear for my condition not even when I started to lose my vision, maybe I need a good cry, it would help with my eye dry condition, but again, we all are different…wishing you the best dogman and don’t forget that we are here for you…hugs from Ohio, USA

I'm sorry for your struggles, I've always thought I was strong minded - but this has done a number on me, but reading your story again, sheds a new light - and I never mean to dismiss anyone else's personal struggles - as you say we're all different. My struggles stem from anger, that despite having all the information and for as much as I can remember taking necessary precautions, I somehow still ended up in this boat - so my venting and frustration stems from me and my actions when I could have avoided it. I have read a lot of your posts, and again, it puts everything into perspective. I have friends who caught this years ago who've battled a battle I would have given up on, and they're still here, still smiling and living their lives. genuine hugs back to you sir. and thank you.

[Tonny2]

                 ojo.             Hi dogman!, i have two dogs…Don’t get me wrong, we are all here to vent and rant, as a matter of fact, I was typing a rant myself to post and when I was about to post my rant, I don’t know what i did, due to my blindness, that my rant West deleted, I felt so frustrated because it takes me a long time to type a post. But I said to myself, it is what it is…as I said, we are here to support each other, sharing our experiences and maybe help others by doing so…if you allow me to give you a suggestion, try to turn the page, right now what it matters is that you know you are pisitive, you treat it and try to be more pisitive about life so can can live a normal and happy life, if you still think that it’s something you can’t handle, seek professional help…reading your post, i thought that it would be a good idea to start a thread about the “horror” we’ve been through with this condition, if you knew what has happened to me, you would be surprised, anyway, I wish you the best and remember that you are not alone, we are here for you…more hugs


Ps. or keep my typos, I’m blind, well, legally blind.

[Dogman]

                 

ojo.             Hi dogman!, i have two dogs…Don’t get me wrong, we are all here to vent and rant, as a matter of fact, I was typing a rant myself to post and when I was about to post my rant, I don’t know what i did, due to my blindness, that my rant West deleted, I felt so frustrated because it takes me a long time to type a post. But I said to myself, it is what it is…as I said, we are here to support each other, sharing our experiences and maybe help others by doing so…if you allow me to give you a suggestion, try to turn the page, right now what it matters is that you know you are pisitive, you treat it and try to be more pisitive about life so can can live a normal and happy life, if you still think that it’s something you can’t handle, seek professional help…reading your post, i thought that it would be a good idea to start a thread about the “horror” we’ve been through with this condition, if you knew what has happened to me, you would be surprised, anyway, I wish you the best and remember that you are not alone, we are here for you…more hugs


Ps. or keep my typos, I’m blind, well, legally blind.

I apologize for not responding sooner, I tend to get here on bursts, and have been traveling a lot. You're a dog person with dogs, the most wonderful pets and friends we could hope for.  Thanks again for talking to me and give your dogs a big pat from me. hugs back.

[Dogman]

Just wanted to give an update on my own experience in switching from Biktarvy to Dovato 5 months ago.

I had been on Biktarvy for 7 months following my initial diagnosis, and it worked well and very fast, I was undetectable after 3 weeks (from VL of 100,000). I had some minor side-effects including facial wasting, not super bad, but enough that I am acutely aware of it. I switched to Dovato after discussion with my doctor in terms of one less drug. I posted an initial update after the switch, this is the 2nd update. My VL is still UD, my CD4's are up to 540 (from 370 3 months earlier, I know this number is unrelated to the drug) and I'm at 20% CD4/CD8 which is slowly getting towards "normal". I have experienced minor sleep pattern changes, but other than that no side-effects at all. I'm not sure if people are interested, but I like reading others experiences so figure someone may be interested in my experience. Wishing everyone a wonderful 2024.

[numbersguy82]

Just wanted to give an update on my own experience in switching from Biktarvy to Dovato 5 months ago.

I had been on Biktarvy for 7 months following my initial diagnosis, and it worked well and very fast, I was undetectable after 3 weeks (from VL of 100,000). I had some minor side-effects including facial wasting, not super bad, but enough that I am acutely aware of it. I switched to Dovato after discussion with my doctor in terms of one less drug. I posted an initial update after the switch, this is the 2nd update. My VL is still UD, my CD4's are up to 540 (from 370 3 months earlier, I know this number is unrelated to the drug) and I'm at 20% CD4/CD8 which is slowly getting towards "normal". I have experienced minor sleep pattern changes, but other than that no side-effects at all. I'm not sure if people are interested, but I like reading others experiences so figure someone may be interested in my experience. Wishing everyone a wonderful 2024.

Sounds like you are def on your way to a fantastic 2024 and beyond. I’m happy for you and please keep us posted!

[Dogman]

Good day,

well I took the longest break between diagnosis and tests, with a 6 month break from my last set of tests. I switched from Biktarvy to Dovato about a year ago - or there abouts.

I don't have my viral load yet, I'm hoping still UD, but my CD4's dropped from 540 to 480 - which is a little disappointing given it's been 6 months. I know this value can vary on an hour to hour basis, so I'm not stressing too much about it, was just hoping for an improved result. I'm nearly 2 years into my initial diag. Otherwise, no side-effects, feel good - haven't even had a cold in more than a year, (of course my overactive mind says "so no cold in over a year perhaps my immune system just isn't responding to invaders",  I guess things are generally ok. Hope everyone here is doing well too.

[Tonny2]

            ojo.          Hello there!… I wouldn’t worry about your CD4 level. Do you know your CD4%?… and yes, from now on, you will be seeing Dracula and DOCTOR every six months. I bet your viral load would be undetectable and that’s what matters more.… Please keep us posted and you are on your way to learn how to leave with HIV… Hugs.

[leatherman]

my CD4's were high 100's, and are now high 500's and UD ( 2 years after diagnosis )

my CD4's dropped from 540 to 480 - which is a little disappointing given it's been 6 months. I know this value can vary on an hour to hour basis, so I'm not stressing too much about it, was just hoping for an improved result. I'm nearly 2 years into my initial diag.

Since you commented again about your cd4s, I thought I could help you out with how you consider them, so you aren't so disappointed.

First, as you correctly stated, the cd4 count is like your blood pressure or temperature - it's a flexible number that changes throughout the day. But did you know that cd4 counts can change by up to 100 points within a day? Your CD4 count of 480 is only 80 points changed....or basically a null change.

No real change? See, that's nothing to be disappointed about. 

Next, one number, even two test results, doesn't mean much. Since CD4s change so much, they need to considered as a trend of at least 3 results over at least 6 months. What was your result prior to the 540? With that third number you could chart a trend. Of course, the more results you can graph out the better you can construct your cd4 trends. Maybe you'll see a graph that a jagged line, that could still be trending upwards.

According to a previous post, you commented that you went from 100 to 540 in 2 years. That's pretty good really. You started meds; your cd4s recovered; and you were well into the healthy range within 2 yrs. That's certainly not disappointing. You started in the AIDS range (<200) and have gone into the healthy range (>400) and you're still doing that well, so that's not disappointing.

Do you know your CD4%?

one of the results in the "lymphocyte subset panel" in blood test results is the CD4% (thanks for mentioning this Tonny). CD4 result is the total cd4 count. CD4 percentage is about your cd4s compared to total lymphocytes. This percentage is a more stable number, much slower to change. I bet you're going to see that (in part because 480 is <100 from your previous result of 540) this percentage hasn't changed at all....and that's not disappointing.

Of course, the caveat to any cd4 discussion is that you can't do anything about them anywhere. Sure better food and exercise, stopping smoking, getting enough sleep, etc can improve the count by a few points, but there's nothing else you can do. Unfortunately, aging will reduce your count. So just living causes a decrease. (ugh. I guess, just don't get old. LOL). I guess though points are a little disappointing. 

But more doesn't mean better; more just means more. We can't measure the strength of cd4s so for some people 50 cd4s could be just as effective as 500 cd4s in other people. While we can't determine cd4 strength, data shows us that a cd4 count <200 is when it's most likely for an AIDS-related disease to occur. So as long as your count is >200, that's not disappointing.

So, all in all, your results at this point just aren't disappointing. To give you a little boost about how well you're doing, compare your results to mine. It took me 24 years to get above 500 cd4s. After being hospitalized twice in two years, barely surviving pneumonia with less than 10 cd4s each time, it took 20 years before my cd4s got over 200 and stayed there. While it was disappointing being hospitalized, I sure can't be disappointed by having some really strong kick-ass cd4s that have kept me alive, and eventually pretty damn healthy, for 40 years living with HIV. (well 40 yrs this Nov but I'm really excited about this great upcoming HIVersary. )

[numbersguy82]

Thank you for continuing to share your journey. I am actually making this same change this week. For me it was less about the medication, and more about consistency and adherence. With my mental health challenges, I hope this will reduce my potentially skipping doses of medication while I’m in a depressive period.

Biktarvy has been a wonder for me, so I am still a bit hesitant to change, but I guess I could always go back if this isn’t working out.

Interested in your VL as that is truly your best indicator of your management.

[Tonny2]

Thank you for continuing to share your journey. I am actually making this same change this week. For me it was less about the medication, and more about consistency and adherence. With my mental health challenges, I hope this will reduce my potentially skipping doses of medication while I’m in a depressive period.

Biktarvy has been a wonder for me, so I am still a bit hesitant to change, but I guess I could always go back if this isn’t working out.

Interested in your VL as that is truly your best indicator of your management.

                 ojo.           @numbersguy82… I don’t want to hijack the OP thread, just let me ask you if you have Talked to your doctor about swishing to
 Dovato and I suppose he knows about your mental issues. Dolutegravir might cause depression, ojo (watch out)…hugs

[Jim Allen]

                 ojo.           @numbersguy82… I don’t want to hijack the OP thread, just let me ask you if you have Talked to your doctor about swishing to
 Dovato and I suppose he knows about your mental issues. Dolutegravir might cause depression, ojo (watch out)…hugs

Don't know about everyone else but I've been taking DTG for years and I'm perfectly sane...

[numbersguy82]

                 ojo.           @numbersguy82… I don’t want to hijack the OP thread, just let me ask you if you have Talked to your doctor about swishing to
 Dovato and I suppose he knows about your mental issues. Dolutegravir might cause depression, ojo (watch out)…hugs

Wow excellent observation Tonny, I honestly haven’t researched that much. I guess I should before Wed when I’m scheduled for the first shot. Thank you 😘

[Dogman]

Since you commented again about your cd4s, I thought I could help you out with how you consider them, so you aren't so disappointed.

Michael, thank you for your sanity check, you must get so tired of repeating this to us nervous "newbies". So this was my first test in 6 months, 480, previous was 540, previous to that was 430, so the increase is happening. I started at 180. My VL this time however was 21, and again, 1 over detectable, I know what you're going to say.  I don't know why I was UD for 1.5 years and the last two have been 29 and 21 respectively. It does cause me anxt.  And thank you. I appreciate you taking the time to take the time. DM.

[Dogman]

Don't know about everyone else but I've been taking DTG for years and I'm perfectly sane...

Thanks for the laugh. Feeling sorry for myself since visiting the doctor. ( no valid reason ), I just hate going in there. Appreciate the laugh, thank you.

[Dogman]

Thank you for continuing to share your journey. I am actually making this same change this week. For me it was less about the medication, and more about consistency and adherence. With my mental health challenges, I hope this will reduce my potentially skipping doses of medication while I’m in a depressive period.

Biktarvy has been a wonder for me, so I am still a bit hesitant to change, but I guess I could always go back if this isn’t working out.

Interested in your VL as that is truly your best indicator of your management.

Thanks for the reply and good luck with the switch. Personally, first couple of weeks, slightly upset stomach - disturbed sleep patterns. As for depression, I'm not sure, I'm down a lot of the time, this all weighs on my like I have 10 tons on my back, I try to fight it by getting outdoors, going to gym - you know normal stuff. 
My VL was 21 ( just got it ), i've been UD since starting on Bik, then swapping to Dovato about a year ago, but last two were 21 and 29 respectively. Doc didn't seem concerned. My CD4/8 % is at 18%. All the best and hope the Dovato works perfectly for you.

[Dogman]

            ojo.          Hello there!… I wouldn’t worry about your CD4 level. Do you know your CD4%?… and yes, from now on, you will be seeing Dracula and DOCTOR every six months. I bet your viral load would be undetectable and that’s what matters more.… Please keep us posted and you are on your way to learn how to leave with HIV… Hugs.

Hi Tonny2, hope your dogs are good.  Thank you, yeah, my % is 18 as of today. I wasn't undetectable, it was 21. Big hugs back.

[Dogman]

So, all in all, your results at this point just aren't disappointing. To give you a little boost about how well you're doing, compare your results to mine. It took me 24 years to get above 500 cd4s. After being hospitalized twice in two years, barely surviving pneumonia with less than 10 cd4s each time, it took 20 years before my cd4s got over 200 and stayed there. While it was disappointing being hospitalized, I sure can't be disappointed by having some really strong kick-ass cd4s that have kept me alive, and eventually pretty damn healthy, for 40 years living with HIV. (well 40 yrs this Nov but I'm really excited about this great upcoming HIVersary. )

40 years - wow, I just visited with an OS friend who's battled for 40 years as well, he's started some brand new drug, an "entry inhibitor", was a bit rough at first, but it's settled down and all in all he's doing just great. Your words are invaluable to us, and I'm going to say it again, whiny newbies who have no clue what you and others have been through. Thank you, and I wish you a happy HIVersary - as hard as that is for me to say :-). All the best and my heart felt thanks. DM

[Jim Allen]

Thanks for the laugh. Feeling sorry for myself since visiting the doctor. ( no valid reason ), I just hate going in there. Appreciate the laugh, thank you.

You're welcome. On a more serious note, I agree with Micheal.

540 to 480, maybe you sneezed before the blood draw...

Your counts are within the average normal range for someone who is not living with HIV, not sure what you want? 450 vs 650 or 850, it doesn't mean better or more effective. I would give you some of mine but mine but although it's a greater count (at the moment) they are useless fuckers.

The CD4 counts can go up or down by 100 points daily and they are not a measurement of overall health. CD4% is a somewhat better measurement but also irrelevant, your VL is suppressed and you have a count above the immediate danger zone, it's actually within average range, some clinics and healthcare providers don't even run CD4 counts anymore during routine check-ups.

Stop focusing on irrelevant numbers, live your life.

[Tonny2]

Hi Tonny2, hope your dogs are good.  Thank you, yeah, my % is 18 as of today. I wasn't undetectable, it was 21. Big hugs back.

                 ojo.             Hi again!… unfortunately, my dog, the oldest one, he was 16 years old died last month. We miss him so much specially his little brother. Lukas. thanks for asking for my babies.


I wish I could find the words to make you feel better but trust me, your numbers are goiod. You might need Someone To Talk To About How You Are Feeling Because Like You Said cama Is Been To Years And You Still Feeling Down… Nobody Said That Living With hiv is easy but we have to be strong for ourselves, and our families, is doable so, if you think the seeking professional help may help you, go ahead and do it. I don’t know old you are but time does not forgive and it’s not coming back.… Hugs and if you need someone to talk to feel free to PM me, I’m not a psychologist, but maybe it will help you to talk to someone who has been living with this condition for 29 years


Ps. forgive my typos

[Tonny2]

Don't know about everyone else but I've been taking DTG for years and I'm perfectly sane...

             ojo.            Poor charlie, she wouldn’t want to see his daddy like that.


You are so funny, Jim you made me laugh

[Jim Allen]

i've been UD since starting on Bik, then swapping to Dovato about a year ago, but last two were 21 and 29 respectively. Doc didn't seem concerned.

Why would the doctor be concerned, 21 and 29 are fully suppressed results (Undetectable).

This means the treatment is working. You always will have a detectable viral load in reality and the viral load will vary between visits, defective copies, reservoir dumpes that are miscounted etc, etc. It just depends on how low the lab being used can measure, some go as low as 1 copy.

Anyhow, your VL results are below 200 and it seems your clinic's lab has a cut-off point of 20 copies, so previously your count was somewhere between 1 and 20 +- and below your clinic's lab capabilities. Even if my results had an odd spike below 1000 or so, I would not stress. 

Your VL is fully suppressed (below 200) and your CD4s count is great  Happy days, congratulations.


Prof. Fiona Lyons (HIV in 2024)
https://forums.poz.com/index.php?topic=77637

Reporting VL below 200 - “harmful medical practice”
https://forums.poz.com/index.php?topic=77575

Low level VL linked to defective copies released from viral reservoir
https://forums.poz.com/index.php?topic=77301

Blips
http://i-base.info/guides/changing/viral-load-blips

Viral Blips Don't Raise the Risk of HIV Treatment Failure
https://www.poz.com/article/viral-blips-raise-risk-hiv-treatment-failure

http://www.aidsmap.com/Spanish-study-gives-reassurance-small-HIV-blips-do-not-predict-treatment-failure/page/3085173/

What’s All This Fuss I Hear About Viral “Blips”?
https://academic.oup.com/cid/article/70/12/2710/5573119

Q&A on persistent low-level viremia.
https://www.healio.com/infectious-disease/hiv-aids/news/online/%7B8373ca63-674d-4015-ac35-f4da653c7415%7D/qa-understanding-persistent-low-level-viremia-in-people-with-hiv

[leatherman]

whiny newbies who have no clue what you and others have been through

I don't think newbies are whiny. I think they just don't know all the facts, and education is always a good idea.

Also, not that you implied this, but I don't talk about the past just to brag. I like to think parts of my story are the education I got. Just cause I learned things through the school of hard knocks doesn't mean other people have to. Back in my day, every med was a trial or error thing in every real sense of the word. Every test result, I was learning right along with the doctors on whether those numbers meant anything or not. Doctors and patients both learned that "starting ARVs as early as possible, instead of waiting until low cd4 levels" and "PLHIV with undetectable viral loads couldn't transmit HIV" long before official reports ever came out. Back then if you wanted to stay alive and have any hope of getting better you had to be educated and you had to hunt for a doctor to find one who wanted to help you stay alive.

So having lived through that, when I read somebody freaking out about cd4 counts, or side effects, or slow recovery, or disclosure, or whatever else is bothering someone, I can't help but step in and explain how "not bad" some results are even when they "look" worrisome. I have learned that worrying about HIV and your health doesn't do a damn thing for you but make your health worse LOL. So I think that hearing about and learning that there's no reason to care about your cd4 count (as long as it's over 200) and that small Viral load blips can happen and "bad results" often mean nothing, especially when they are a one-off thing, are just part of the peer support I've been doing for decades.

ok. so i wrote all that crap early and then went to mow the yard, jump in the pool, and play outside with my puppers. I came back to find this thread blowing up, so here's a few final thoughts:

"I'm perfectly sane..." <InsaneHome.gif>
well, that's f-ing hilarious!!!

"but last two were 21 and 29 respectively"
suppressed viral load less than 200 is successfully treated HIV, so the rule of thumb is:
Cd4s < 200 = BAD
VL < 200 = GOOD

[Dogman]

You're welcome. On a more serious note, I agree with Micheal.

540 to 480, maybe you sneezed before the blood draw...

Stop focusing on irrelevant numbers, live your life.

I like your Irish honesty, and I know you're right. I have a particularly pedantic doctor who keeps telling me how "unwell" I am ( in not so many words ), he made me go for a heart check, alluding to how bad it would be, well it came back very very good, no issue at all. It's the same with this. So I leave the clinic in a mild state of panic, when in fact they're not bad, and I've said it to him, what about the measure of how I feel, which is perfectly fine, my day to day has not changed one bit.  I feel a bit better, thank you again.

[Dogman]

ok. so i wrote all that crap early and then went to mow the yard, jump in the pool, and play outside with my puppers. I came back to find this thread blowing up, so here's a few final thoughts:

"I'm perfectly sane..." <InsaneHome.gif>
well, that's f-ing hilarious!!!

"but last two were 21 and 29 respectively"
suppressed viral load less than 200 is successfully treated HIV, so the rule of thumb is:
Cd4s < 200 = BAD
VL < 200 = GOOD

I would never allude to what you stated, and I know you didn't think that.  I'd admire people like you and your tenacity, like my friend I mentioned, it's a humble admiration, and realization. I'm mid 60's, look mid 40's ;-). Thank you enjoy your dogs and pool. Appreciate you and hope you have a great summer.

[leatherman]

I'm mid 60's, look mid 40's ;-). Thank you enjoy your dogs and pool. Appreciate you and hope you have a great summer.

I'm 62, hope I look 52 (at least that's the age people guess), and act like 42!
I looooove summer. speedos and the sun! nothing makes me happier.

I hope you and everyone have a good summer too!