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Author Topic: Ways to lower CD8?  (Read 1927 times)

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Offline Cerrid

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  • Posts: 500
  • only as good as your last haircut
Ways to lower CD8?
« on: December 31, 2009, 09:59:56 AM »
Hey folks,

my CD4 numbers have been hovering around 450-550 for 18 months now, which isn't so bad considering I started with only 1 CD4 42 months ago. I'm still on my first regimen (Epzicom/Kaletra) and VL has been undetectable for 34 months. No co-infections. So far so good.

Now, what's been bothering my doc and me, is the permanent and extraordinary high number of CD8 which is usually around 2700-3300. From a mathematial point of view, it ruins the CD4/CD8 ratio which would otherwise look alright. From a medial point of view, this number tells of a highly activated immune system with enough killer cells to fill a stadium.

To decrease the CD8ers while leaving the CD4ers intact, my doc suggested low-dosed cortisone for a few weeks to see what happens. I'm a little afraid because of possible side-effects. What do you think? Do you know of any methods to lower CD8 and what are the benefits apart from improving the ratio?
"Boredom is always counterrevolutionary. Always." (Guy Debord)

Offline TopherK

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Re: Ways to lower CD8?
« Reply #1 on: December 31, 2009, 01:01:48 PM »
Cerrid -

Iíve experienced a similar elevation in my CD8 levels over the past three years.  According to my docs, this was one of the issues involved with the intractable folliculitis that I had over my entire torso.  The condition eventually became mind-blowingly itchy and my skin was so inflamed that my quality of life was affected.  Treatment with steroids to reduce the inflammation was appropriate since elevated CD8ís are an indicator of systemic inflammation. 

This treatment was a bit tricky for me, though, since I contracted Hepatitis B ten years ago.  The acute viral infection resolved itself - after I had the joy of experiencing liver failure and hepatic coma - but apparently an extended course of steroid treatment can reactivate the Hepatitis virus.  As a result I also started on a HAART regimen that included Truvada, which is known to control Hep B virus.

There is a growing body of literature (which Iím being too lazy to cite right now) that details inflammation-induced organ damage with HIV as the smoking gun.  These studies were part of the evidence in support of the recent HHS specialist panel arguments to begin HAART earlier.  Despite the fact that my CD4 and viral load numbers were terrific, the studies prompted me to do whatever was necessary to get my inflammation under control as quickly as possible.  I preferred this course of treatment to the potential of dealing with more significant organ failure issues down the road.  Since steroids do have side-effects their use should be weighed carefully.  For me, they have changed my life for the better since my skin is (finally) clearing up and last month my CD8ís were on the decline.  My next lab draw is in a week and I expect to see a significant drop.

I'm sure there are others on the forums with more formal medical knowledge than mine, but hopefully this will help you weigh your options.  Best of luck with your treatment decision...
Diagnosed August 17, 2005
12 Jul  07 v/l 722   CD4 558  31%
10 Oct 07 v/l 1132  CD4 456  21%
08 Feb 08 v/l <50!  CD4 510  30%
09 May 08 v/l 1128  CD4 669  30%
06 Aug 08 v/l 1126  CD4 618  29%
06 Dec 08 v/l 248    CD4 630  30%
01 May 09 v/l 2626  CD4 529  28%
05 Jul 09 v/l 2616    CD4 524  28%
21 Oct 09 v/l 4201  CD4 763  30%
19 Nov 09 - start Truvada/Reyataz/Norvir & Predisone for chronic inflammation
11 Dec 09 v/l 114    CD4 700  31% - switch Reyataz/Norvir to Isentress
currently  v/l <50  CD4 ~560  30%


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